New Hampshire Nursing News - July 2018

Official Newsletter of New Hampshire Nurses Association 

Quarterly publication direct mailed to approximately 17,000 Registered Nurses, LPNs, and LNAs in New Hampshire. 

www.NHNurses.org 

July 2018 | Vol. 42 No. 3 

Nurses Celebrate 

Nurses Week 2018 

Please be sure to notify us with address 

changes/corrections. We have a very large list 

to keep updated. If the nurse listed no longer 

lives at this address–please notify us to 

discontinue delivery. Thank You! 

Please call (603) 225-3783 or email 

to office@nhnurses.org with 

Nursing News in the subject line. 

Nurses celebrated their professional identity in style May 

2018. The first Excellence in Nursing Awards, sponsored 

by NHNA and New Hampshire Magazine celebrated 

13 nurses from cardiology to psychiatry, acute care 

to palliative care, pediatrics to gerontology, advanced 

practice, education and leadership. In the next issue of 

the NHNN, we will report on the celebratory evening 

event to honor these colleagues. 

New Hampshire nurses participated in the Boston Red 

Sox annual Nurse Appreciation Night at Fenway Park 

on May 15. 1,400 nurses were nominated to throw out 

the first pitch and 10 qualified as finalists. But New 

Hampshire’s own Jeffrey Ballard won the honor. Ballard 

practices at Manchester VA Medical Center’s Home Based 

Primary Care team. He is also a veteran, having served 

as a member of the Army National Guard for nearly 20 

years. Wounded in Afghanistan, Ballard now helps elderly 

veterans maintain their independence. He credits the 

position for giving him hope again after his injuries. Ballard 

has been with the VA for nearly five years now. 

Jeffrey Ballard, RN 

Around the state, hospitals and nursing facilities 

celebrated the excellence in patient care that nurses 

deliver on a daily, hourly and minute by minute basis. 

Nurses Week continued on page 4 

Index 

President’s Message .......................2 

From the ED's Desk........................3 

2018 Clint Jones Award Announced............4 

NHNA Members Serving on ANA Committees.....5 

New Hampshire Nurses Association Position 

on the Requirement of Bachelor's Degree in 

Nursing (BSN) for Continued Practice..........6 

In My Opinion ............................7 

Board of Nursing News......................7 

School of Nursing News.....................8 

Welcome New and Returning NHNA Members.....9 

2018 Graduating Student Conference....... 10-11 

NCLEX Reconsidered...................... 12 

Kudos................................. 12 

From the Bookshelf Movies.................. 13 

In Memory of Our Colleagues............. 14-15 

Second Annual Nursing Research Symposium.... 16 

When Caring Isn't Easy: Managing Responses 

to Our "Trigger" Patients.................. 17 

Nutrition Message: How Bad is Chocolate, Really? ... 18 

SAVE THE DATE 

current resident or 

Presort Standard 

US Postage 

PAID 

Permit #14 

Princeton, MN 

55371 

NHNA Annual Banquet 

September 21, 2018 

5K Nursing Race 

October 20, 2018

Page 2 • New Hampshire Nursing News July, August, September 2018 

Guidelines for Submissions to NH Nursing News 

NH Nursing News (NHNN) is the official publication 

of the NH Nurses’ Association (NHNA), published 

quarterly – and available in PDF format at our website: 

www.nhnurses.org. Views expressed are solely 

those of the guest authors or persons quoted and do 

not necessarily reflect NHNA views or those of the 

publisher, Arthur L. Davis Publishing Agency, Inc. 

NHNA welcomes submission of nursing and health 

related news items, original articles, research abstracts, 

and other pertinent contributions. We encourage short 

summaries and brief abstracts as well as lengthier 

reports and original works. An “article for reprint” may 

be considered if accompanied by written permission 

from the author or publisher. Authors do not need to be 

NHNA members.* 

Manuscript Format and Submission: 

Articles should be submitted as double spaced WORD 

documents (.doc format vs. .docx, please) in 12 pt. font 

without embedded photos. Photos should be attached 

separately in JPG format and include captions. 

Submissions should include the article’s title plus 

author’s name, credentials, organization / employer 

represented, and contact information. Authors should 

state any potential conflict of interest and identify any 

applicable commercial affiliation. Email as attachments 

to office@nhnurses.org with NN 

Submission in the subject line. 

Publication Selection and 

Rights: 

Articles will be selected for 

publication based on the 

topic of interest, adherence 

to publication deadlines, 

quality of writing and peer 

review. *When there is 

space for one article and two 

of equal interest are under review, 

preference will be given to NHNA members. 

NHNA reserves the right to edit articles to meet style 

and space limitations. Publication and reprint rights 

are also reserved by NHNA. Feel free to call us any 

additional questions at 877-810-5972. 

Advertising: 

Product, program, promotional or service 

announcements are usually considered advertisements 

vs. news. To place an ad, contact: Arthur L. Davis 

Publishing Agency, Inc. Email sales@aldpub.com or 

call 800-626-4081. Ad sales fund publication and 

mailing of NH Nursing News and are not paid to 

NHNA. 

PRESIDENT’S MESSAGE 

The New Hampshire Nurses 

Association has worked 

hard tending their garden, 

enrichening the soil and 

planting the seeds which 

are starting to germinate 

and we want to bring you 

in to enjoy the harvest. We 

have launched a new web 

site, updated our 2017-2020 

Strategic Plan, partnered 

with New Hampshire 

Magazine to conduct the 

first awards for our state’s 

Carlene Ferrier 

most excellent nurses, and elevated our voice as strong 

supporters of health and healthcare legislation that 

impacts our patients and our profession. The NHNA 

Board of Directors has also begun the ambitious goal 

of completing The Standards for Excellence, An Ethics 

and Accountability Program for the Nonprofit sector. 

This may take two years to complete, but we are slowly 

making progress through the sixty-seven standards. 

Recognizing that our most important tool to connect 

with you is our web site, we made the bold decision 

to invest in our own platform under Nursing Network 

to enable us to fully control timing, frequency and 

content, as well as potential non-dues revenue streams 

and utilize a system that is user friendly that we can 

update and manage ourselves. Please refer to “From the 

ED’s Desk,” which provides detail on how to navigate 

and where to find what you are looking for. See for 

yourself how easy it is to use. 

It was my pleasure to visit each commission and 

have an opportunity to get to know the commission 

members in person to update our Strategic Plan. 

You’ll find it under About Us/Board Compliance on 

the website. Once again, I was impressed by the 

talent, commitment, and thoughtfulness of all of the 

35 Tilton Road • Tilton, NH 03276 

www.belknapsubaru.com 

Mark Mallahan 

General Sales Manager 

mmallahan@belknapsubaru.com 

(603) 729-1300 

(800) 358-4029 

Fax (603) 729-1301 

commission members. You will find a list of the names 

of members under About Us/NHNA Commissions/ 

then select one of the commissions: Commission 

on Government Affairs, Commission on Continuing 

Education, and Commission on Nursing Practice. 

Following those links will lead you to read about the 

immense efforts that each commission puts forth 

to achieve our mission. I was humbled to learn that 

several members have been serving NHNA for more 

than a decade and delighted that we have many new 

members as well. 

Based on the success of the first publication of the 

Excellence in Nursing awards, we can count on a 

new annual program and event that will highlight 

the innovative work that NH nurses do every day. 

In the past we have always recognized a few nurses 

for special awards at our annual meeting. But this 

presents an opportunity to educate the public about 

what nurses really do at the bedside and beyond. It 

also provides a platform for this incredible work to be 

heard regularly. With the experience and knowledge 

of having navigated the procedures this first year, we 

will strive to perfect the categories, submission, and 

criteria for judging to continue to ensure an ethical and 

comprehensive process for the future. 

Our Nurse Executive Director, Joan Widmer, and 

members of the Commission on Government Affairs 

have spent countless hours at the state house providing 

oral and written testimony on the bills that our 

commission and membership has selected to prioritize 

and follow. Joan has been quoted in newspapers around 

the state and called upon to be interviewed by NHPR 

and other media outlets. She is helping us to achieve 

our goal of lobbying for legislation that will support 

our mission and is successful because she is a nurse, is 

very well spoken and she represents our profession in 

a passionate and personal way. Visit the photo gallery 

advocacy section of our web site to learn more. 

Lastly, the NHNA Board of Directors is working 

diligently to complete assessments for performance 

benchmarks in five areas: 

I. Mission Strategy and Evaluation 

II. Leadership: Board, Staff and Volunteers 

III. Legal Compliance and Ethics 

IV. Finance and operations 

V. Resource development 

The goal of this exercise is to evaluate our organization, 

educate board members on board compliance, use 

the guidelines for improving performance and prepare 

for accreditation when and if we decide to pursue this 

endeavor. 

New Hampshire 

NURSING NEWS 

Vol. 42 No. 3 

Official publication of the New Hampshire Nurses’ 

Association (NHNA), a constituent member of the 

American Nurses Association. Published quarterly 

every January, April, July and October. Library 

subscription rate is $24. ISSN 0029-6538 

Editorial Offices 

New Hampshire Nurses Association, 25 Hall St., Unit 

1E, Concord, NH 03301. Ph (877) 810-5972, E-mail 

office@NHNurses.org 

Editor: Susan Fetzer, RN, PhD 

NHNA Staff 

Joan Widmer, Nurse Executive Director 

NURSING NEWS is indexed in the Cumulative Nursing 

Index to Nursing and Allied Health Literature (CINAHL) 

and International Nursing Index. 

For advertising rates and information, please 

contact Arthur L. Davis Publishing Agency, Inc., 

517 Washington Street, PO Box 216, Cedar Falls, 

Iowa 50613, (800) 626-4081, sales@aldpub.com. 

NHNA and the Arthur L. Davis Publishing Agency, 

Inc. reserve the right to reject any advertisement. 

Responsibility for errors in advertising is limited to 

corrections in the next issue or refund of price of 

advertisement. 

Acceptance of advertising does not imply 

endorsement or approval by the New Hampshire 

Nurses Association of products advertised, the 

advertisers, or the claims made. Rejection of an 

advertisement does not imply a product offered for 

advertising is without merit, or that the manufacturer 

lacks integrity, or that this association disapproves 

of the product or its use. NHNA and the Arthur L. 

Davis Publishing Agency, Inc. shall not be held liable 

for any consequences resulting from purchase or use 

of an advertiser’s product. Articles appearing in this 

publication express the opinions of the authors; they 

do not necessarily reflect views of the staff, board, 

or membership of NHNA or those of the national or 

local associations. 

VISION STATEMENT 

Empower New Hampshire nurses as leaders in 

advancing the profession of nursing and the health of 

New Hampshire. 

MISSION STATEMENT 

NHNA, as a constituent member of the American Nurses 

Association, exists to promote the practice, development 

and well being of NH nurses through education, 

empowerment and healthcare advocacy. 

Adopted 10-20-2010. 

It is a very exciting time to be involved with NHNA, 

and we don’t want to miss the occasion to thank 

you sincerely if you are among the many incredible 

volunteers who already contribute to our mission and 

to welcome and encourage those of you who have 

not joined us yet. We will be developing our slate of 

officers and commission members for election soon 

and anticipate many more short-term tasks that you can 

become involved. It really is an amazing group of nurses 

and we don’t want you to miss out. I read a quote 

recently by John Harrigan which captures the message I 

am trying to convey in a lovely way,” Happiness held is 

the seed. Happiness shared is the flower.” 

Carlene

July, August, September 2018 New Hampshire Nursing News • Page 3 

FROM THE ED’S DESK 

One of my primary goals for the New Hampshire Nurses Association (NHNA) 

when I first accepted the position of Nurse Executive Director was finally realized 

on May 9th with the launch of the new NHNA website. I am so excited to have 

our most important communication tool with our membership, and the nurses of 

New Hampshire, located on a platform that offers the latest technologies in website 

management. The website address (or URL) remains unchanged: www.nhnurses.org. 

Take a look at our home page below: 

On the main menu, towards the bottom, is a new page 

for the New Hampshire Action Coalition (NHAC). NHNA 

has a long standing partnership with the NHAC and so 

has decided to provide NHAC with a page for posting 

information about their programs and resources they want 

to share. 

The “Stay Connected” button is a mechanism by which 

NHNA can stay in touch with NHNA members. It works 

much like Facebook. Just click 

on the “Follow” button and 

you will receive automatic 

updates when we post News & 

Announcements or Upcoming 

Events. 

Joan Widmer 

One of the features of the Network Nursing platform that we have not yet activated is 

the ability for members to search for other members. This would allow a member to 

reach out and communicate directly with other members through the website. Here 

again it would work much like Facebook. A member would “ask” another member if 

they wanted to communicate with each other. The other member could then accept 

the communication or disregard it. Because this feature, once activated, provides 

access to the names and town of residence for all members, the NHNA Board of 

Directors felt our membership should be queried before activating this feature. We 

value the privacy of NHNA members and felt the members should decide if the 

benefits of the feature merit the availability of member names and towns of residence 

on the website. This will become a question on our fall election ballot. 

Currently our entire website is open to the public; you do not have to be a member 

to view any or all of the content. One of the new features of this platform is the ability 

to create member only content. The NHNA Board of Directors has currently opted to 

keep the website open, but this could change should the membership wish. 

The primary navigation menu appears on the left hand side of the screen. A carrot 

indicates subpages exist below the primary page on the menu; clicking on the carrot 

will provide you with listing of these subpages. The website is designed to function 

easily regardless of the computing platform being used to access it, laptop, tablet or 

smart phone. 

The “News & Announcements” section on the home page displays the two most 

recent news announcements, but you can quickly query for more announcements by 

clicking on “News & Announcements” on the main menu. 

Similarly, the “Upcoming Events” section on the home page provides the three most 

recent upcoming events. The “Search Upcoming Events” on the main menu provides 

a complete list of future NHNA events. Because our website is hosted on the Nursing 

Network platform, members will also be able to search on upcoming events for other 

Nursing Network organizations (and Nursing Networks platform is limited exclusively 

to nursing organizations). Simply use the “Search Upcoming Events” tab on the main 

menu and then click on “Find more industry events on Nursing Network.” 

One of the newest features to the website is the “Photo Gallery” (item 3 on the main 

menu). Check the gallery out and see photos from NHNA events dating back to 

January 2017. Take a look at photos from the Graduating Student Conference (March 

2018), the Legislative Town Hall Form (January 2018) and much more. Here is a screen 

shot of the Photo Gallery: 

Another important feature of the new website platform is the ability to send email 

blasts not only to members, but also to non-members. Historically, non-member 

nurses have attended many of our events. We can now add these non-member 

names and email addresses to this non-member database so we can share information 

about upcoming programs directly with them, and or, encourage them to join the 

organization. We can also add the names and email addresses of student nurses that 

attend our Graduating Student Conference and encourage them to join NHNA when 

they are credentialed later in the year. 

Reinventing the NHNA website is a dream come true, but it could not have been 

accomplished without the help of several others. Eileen Rodgers, the Membership and 

Communications Specialist with the Northeast Multi-state Division, was a valuable 

partner in this enterprise, as was Dan Cohen from Nursing Network. Carlene Ferrier, 

NHNA President, was a big help in going through every webpage and clicking 

on every link to test the website before launch. She also provided some insightful 

suggestions for improving the layout of some pages. 

Now it’s on to my next member communication goal, bi-monthly electronic flash to 

consolidate communications to membership. The new website platform fully supports 

this from a technology standpoint. Test it out and send me a message! We’d love to 

hear your impression of this new benefit! 

Joan 

I’ve identified as many people as I could in these images. If you recognize yourself 

and want your name added to the photo legend, just send me an email and I’ll add 

your name. You can easily reach NHNA by going to the “Contact Us” tab on the main 

menu. 

The home page also has links to our Facebook and Twitter accounts. We frequently 

post information to our social media accounts, so if you have a Facebook or Twitter 

account of your own you can now Friend or Follow NHNA with only a click.


Nurses Week continued from page 1 

2018 Clint 

Jones Award 

Announced 

Littleton Regional Healthcare celebrated Nurses 

Week with an incredible display of local student 

artistry. Kindergarten through Grade 6 artists from 

Bethlehem Elementary, Lafayette Regional, Lakeway 

Elementary, the Landaff Blue School, Lisbon 

Regional and Whitefield Elementary, were asked 

to create a poster with the theme “How Do Nurses 

Help the People in Our Community Stay Healthy 

and Happy?” The hallways at Littleton Regional 

Healthcare were full of creative posters made by 

269 of these area students. Three students from 

each school will be awarded with ribbons for their 

exceptional work. Koren Superchi, RNC-OB, MSN, 

Vice President of Patient Care Services at LRH notes, 

“Nurses and staff at LRH look forward to the posters 

each and every year. This contest is very important 

to everyone at Littleton Regional, particularly the 

nursing staff, as it encourages young students in the 

area to think about nursing as a career choice when 

they grow up." 

Portsmouth Regional Hospital announced its first 

Daisy Award winner during National Nurses’ Week 

– Breast Cancer Nurse Navigator Cynthia Cote, BS, 

APRN. Cynthia was nominated by a very grateful 

patient and her nomination was supported by her 

nursing peers. In Cynthia’s role as breast cancer nurse 

navigator, she uses her clinical nursing expertise 

to guide patients, families and their caregivers to 

informed decision-making and supportive care across 

the cancer continuum. 

Isaac Hirschfeld receives the Clint Jones Award 

from Mrs. Leslie Jones and son Matt Jones. 

The Foundation for Healthy Communities announced 

that Isaac Hirschfeld, RN, Elliot Health System, as 

the 2018 recipient of the Clint M. Jones Nursing 

Award. Elliot Health System set two records with 

the Clint Jones Nursing Award Program this year, 

as this is first time the program has had a male 

recipient and the third year in a row that a nurse from 

Elliot Health System has received this prestigious 

award. The award recognizes a registered nurse 

practicing in New Hampshire for at least one year 

but not more than six years, who exemplifies quality, 

compassionate nursing care and demonstrates a 

commitment to a career in nursing. Hirschfeld, 

a resident of Allenstown and a graduate of the 

University of New Hampshire, received the annual 

award in front of his peers and family during a 

special Nurses Week. 

Hirschfeld joined the staff at Elliot Hospital in 2013 

and currently serves on the hospital’s Fitch Unit 

working with patients and their families. He won 

Novice Nurse of the Year in his first year with Elliot 

for his leadership, professionalism and dedication to 

improving the quality and delivery of patient care. 

In nominating Hirschfeld for the award, Sharon 

Kostansek, RN, Clinical Nurse Manager, cited his 

exemplary dedication as a nurse, as well as his 

compassion and commitment to his patients and 

their families. “When I think of why the Clint Jones 

Nursing Award was developed, I think of Isaac’s 

extraordinary enthusiasm and commitment to our 

patients and the Elliot family,” stated Kostansek. 

“Isaac is an exemplary nurse who continues to give 

and go above and beyond for his patients and his 

colleagues, and we couldn’t be more grateful to have 

him at our patients’ bedside.” 

The Clint Jones Nursing Award was created in 

2006 by the Foundation for Healthy Communities 

to honor the memory of the former director of the 

Foundation’s N.H. Nursing Workforce Partnership. 

Between November 2002 and February 2005, the 

N.H. Nursing Workforce Partnership, under the 

direction of Clint Jones, distributed millions of dollars 

in forgivable loans to hundreds of aspiring nurses in 

college and practicing nurses who received specialty 

training or advanced degrees. As they have every 

year, Clint’s family, represented by his wife, Leslie 

and son, Matt, attended the ceremony held at Elliot 

Hospital to present the award to Hirschfeld. “It’s 

always humbling to recognize nurses throughout 

the state for their commitment to delivering 

compassionate care to those when they need it 

most,” stated Clint Jones’ son, Matt Jones. “We 

congratulate Isaac on receiving this award, but more 

importantly we thank him for his tireless commitment 

to his patients and their families.”


New NHNA 

NHNA is pleased to announce the migration to 

a new website. While the web address (www. 

nhnurses.org) remains the same; the new site is 

now hosted by Nursing Network and provides 

a better opportunity to keep nurses and NHNA 

members apprised of the latest news and 

information from NHNA. 

Browsing through the new website with an 

updated look and feel, all the content from the 

old website has been transferred to the new 

platform, with some changes in the layout. There 

are also many new features. 

Check out the new photo gallery, which includes 

photos from events since January 2017. Second, 

the Upcoming Events section has been expanded 

and allows sharing information on upcoming 

events from affiliated nursing organizations as 

well as our own. Third, the website is integrated 

with the NHNA membership database and 

allows for members to communicate with other 

members through the website. Fourth, the 

website is linked to NHNA social media sites. 

Finally, the website has a feature that will enable 

launching of an e-flash in the future. 

For NHNA members, a new member account 

will be created on your behalf to allow 

you to access member-only sections of the 

NHNA website and to receive memberdirected 

communication, such as messages, 

announcements and upcoming event invites. 

NHNA looks forward to your feedback on this 

new format! 

NHNA Members Serving on 

ANA Committees 

Two NHNA members are currently 

serving on American Nurses Association 

Committees. 

In September of 2017, Sherrie Palmieri, 

Dean of Faculty Center for Faculty 

Excellence at Chamberlain University 

and a member of NHNA’s Commission 

on Government Affairs, was nominated 

by the NHNA Board of Directors and 

appointed as an alternate to the ANA 

Professional Policy Committee. Dr. 

Palmieri’s prior experience in working 

on an ANA national committee and 

co-author and subject matter expert 

for ANA’s Nursing Knowledge Center’s 

Gerontological Nurse Certification 

Review Course provided support for her 

appointment. 

The Professional Policy Committee is a 

standing committee of the Membership 

Assembly, ANA’s governing body. One of 

the key responsibilities of the Membership 

Assembly is to determine policy and 

positions for the Association. The 

Professional Policy Committee, formerly 

the Reference Committee, supports the 

development of professional policy by 

Sherrie Palmieri 

Pam DiNapoli 

Make a Difference 

While Making a Living. 

WE’RE SEEKING RNs, LPNs & LNAs 

Join a dynamic, caring organization with 

professional growth opportunities where 

you can grow your 

career while making 

a difference in the 

lives of our residents. 

As a member of the 

RiverWoods healthcare 

team, you will enjoy high 

staff to resident ratios, 

job autonomy, tuition 

reimbursement and competitive pay in a 

beautiful work environment. 

“RiverWoods truly cares about 

their residents and employees 

and is a wonderful place to 

work. As a newer employee, I 

can see why so many have such 

a long work history here and are 

proud to say they’ll retire from 

RiverWoods.” Cheryl, LNA 

disseminating a Call for Policy Proposals 

to all ANA members. The input from the 

Call informs the professional policy issues 

discussed at the annual Membership 

Assembly meeting. Professional policies 

are also developed via Professional Issues 

Panels and the ANA Board of Directors. 

In April of 2018, Pam DiNapoli was 

appointed to the Advisory Committee of the 

#EndNurseAbuse Professional Issues Panel. 

Dr. DiNapoli is an Associate Professor 

of Nursing at the University of New 

Hampshire, the Coordinator Evidence Based 

Practice, Research and Quality at Catholic 

Medical Center and Chair of NHNA’s 

Commission on Government Affairs. She 

has extensive experience serving on statewide 

committees and panels. 

The work of the Professional Issues Panel 

began May 2018 and lasts approximately 

six months. Advisory Committee members 

will provide feedback, additional 

information and advice to ANA and the 

Steering Committee regarding the direction 

of the policy development through virtual 

dialogue and research via an online 

platform. 

Visit RiverWoodsRC.org/joinourteam 

to view our current openings or call 

603.658.1541 to learn more. 

Integrity • Compassion 

Communication • Fun 

Next Step Healthcare is the largest leading provider of post-acute 

care in Massachusetts. 

We promote a culture in which we inspire excellence one 

step at a time. 

We have positions available for various locations in 

Massachusetts, New Hampshire and Maine. We offer competitive 

wages and benefits including but not limited to: BCBS Medical, 

Dental, Vision, Life Insurance, EAP, Tuition Forgiveness for new 

graduate RNs and LPNs, and paid time off. 

http://nextstephealthcare.applytojob.com/apply


New Hampshire Nurses Association Position on the 

Requirement of Bachelor’s Degree in Nursing (BSN) for 

Continued Practice 

Adopted: April 12, 2018 

The New Hampshire Nurses Association recognizes 

that the nurse of the future is the Baccalaureate 

Nurse. It is the position of the New Hampshire 

Nurses Association that there will be a voluntary 

commitment to advancement of nursing education 

beyond the Associate Degree in Nursing, and 

that this commitment helps to ensure quality 

patient outcomes. The choice to pursue continued 

education should be supported and encouraged by 

educators and employers of Registered Nurses. It is 

recommended that newly licensed nurses set a goal 

of a Bachelor’s Degree in nursing within ten years of 

licensure. 

NHNA has taken this position in recognition of 

statements of the stances of national professional 

nursing organizations. In 2008 the ANA House 

of Delegates resolved, “that the American Nurses 

Association support initiatives to require registered 

nurses (RNs) to obtain a baccalaureate degree 

in nursing within ten years after initial licensure, 

exempting (grand parenting) those individuals who 

are licensed or enrolled as a student in a nursing 

program at the time legislation is enacted; and 

be it further resolved, that the American Nurses 

Association advocates for and promotes legislative 

and educational activities that support advanced 

education in nursing” (O’Brien & Gural, 2008). This 

declaration is consistent with the more recent May 

2010 position of the Tri-Council for Nursing - a 

long-standing collaboration between the American 

Association of Colleges of Nursing, American 

Nurses Association, American Organization of 

Nurse Executives, and National League for Nursing 

(Educational Advancement, 2018) 

In this consensus position “The Tri-Council 

organizations agree that a more highly educated 

nursing profession is no longer a preferred future; 

it is a necessary future in order to meet the nursing 

needs of the nation and to deliver effective and 

safe care.” Finally this initiative is in alignment 

with specialty nurses associations such as the 

National Association of School Nurses. NHNA 

encourages a collaborative, voluntary effort among 

key stakeholders with the goal of providing quality 

nursing care to the citizens of New Hampshire. 

The position is based on the following: 

• It encourages a culture of excellence in 

which nurses seek continued education with 

the support of employers and educators. 

It is recognized that excellence in the 

ever changing health care environment 

necessitates strengthening RN leadership 

and inter-disciplinary collaborative 

competencies through lifelong learning. 

• Research has demonstrated that educational 

advancement improves patient outcomes 

through the use of evidence based 

practice and critical thinking. Educational 

advancement supports a culture of 

professional credibility and interdisciplinary 

respect from health care professionals who 

already recognized the value of advanced 

education. 

It will take a commitment by RNs, educators 

and employers for educational advancement to 

become a reality. Continuing clear and consistent 

communication regarding the value of baccalaureate 

level education in the associate degree academic 

setting is necessary in fostering a professional ethic 

of lifelong learning. Each practice setting will be 

challenged with mapping strategies designed to 

create and sustain an environment in which RN 

educational advancement is valued and rewarded. 

Furthermore, to support this transition, there must 

be ongoing academic and clinical partnerships that 

seek solutions to the problem of potential barriers to 

furthering one’s education. 

Concern that legislation or regulation of 

advancement in nursing education will contribute to 

the nursing shortage or strain existing BS programs is 

unfounded. Over 90% surveyed New Hampshire RN 

respondents are employed (NHAC, 2017) with RN 

vacancy rates reported at less than 5.7% by the New 

Hampshire Hospital Association. 

In 2015, 60.4% of New Hampshire RN respondents 

reported having a baccalaureate or higher degree, 

nationally that percentage is 65% (NHAC, 2017). 

The New Hampshire Nurses Association encourages 

Associate Degree Programs to continue to work 

with colleges and universities to provide seamless 

access to advanced education. Furthermore, we look 

for employers to find creative solutions that afford 

nurses within practice settings the opportunity to 

achieve the goal of advanced education in nursing. 

Together, this collaborative effort will enable nurses 

to practice as full partners on multidisciplinary 

teams, increase professional satisfaction, and 

improve health care outcomes. Supporting and 

facilitating voluntary advancement of nursing 

education beyond the ADN will position New 

Hampshire Nurses as leaders in the profession of 

nursing. 

References 

O’Brien, L., & Gural, L. (2008, June 27). Educational 

Advancement for Registered Nurses. Paper presented 

at the meeting of the American Nurses Association 

2008 House of Delegates. Washington, DC 

Educational advancement of registered nurses: A 

consensus position: A policy statement from the Tri- 

Council for Nursing: American Association of Colleges 

of Nursing (AACN), American Nurses Association 

(ANA), American Organization of Nurse Executives 

(AONE), National League for Nursing (NLN). Retrieved 

from: http://www.aacn.nche.edu/Education/pdf/ 

TricouncilEdStatement.pdf 

New Hampshire Action Coalition (2017). New Hampshire 

registered nurse supply: 2014-2016 workforce 

characteristics. 

Registered Nurse Psych Care Coordinator 

We are seeking a Registered Nurse Psychiatric Care Coordinator to 

work with our Behavioral Health and Psychiatric Team at Northern 

Human Services. This position will include (but not limited) to the 

following responsibilities: 

• Manage Patient Health Assessments/Screenings 

•Monitor Self Medication Programs 

• Pre-screen/Schedule Psychiatric Appointments 

• Specimen Collection • Prescription Pre-authorizations 

• Coordinate Treatment Plans with community health partners 

• Health Counseling • Documentation Auditing 

• Assists Psychiatrist with Patient Management 

• Health Counseling and Monitoring for clients with psychiatric diagnoses 

The candidate must be able to work on a team with other behavioral health 

providers in a busy clinical outpatient environment. Moderate computer skills are 

required (MS Word, Excel, Outlook) including extensive use of electronic medical 

record for documentation management and billing. 

Requirements: Registered Nursing Degree from an accredited program, State of 

NH license plus minimum of two years licensed nursing experience; knowledge of 

state laws relating to emergency treatment, training/storage/administration and 

disposal of medications; experience with clients with mental illness is preferred 

including some knowledge of current accepted treatment approaches and concerns. 

Northern Human Services offers an excellent benefits package including medical, 

dental, employer paid group Life, LTD & AD&D insurances, 11 paid holidays, 

generous paid time off and more. 

Interested candidates, please send your resume with cover letter to Eve V. Klotz, 

LICSW, Director of Behavioral Health by e-mail, eklotz@northernhs.org, or mail, The Mental 

Health Center, 25 W. Main St., Conway, NH 03818, or fax to 603-447-1021. 

This position requires a valid driver’s license, proof of adequate auto insurance, and the 

completion of criminal, driving and background records checks. This agency is an Equal 

Opportunity Employer and provider. 

There are approximately 500 school nurses 

in New Hampshire, serving 618 public and 

private schools. The role of the professional 

school nurse is currently defined by New 

Hampshire School Nurse Certification 

Law (RSA 200:29), with the current 

rules approved by JLCAR (Ed 306.12). 

Certification ensures a professional 

level of qualification for the position 

of school nurse, which supports a 

minimal standard of care for students 

with acute and chronic health needs 

in school. 

Two bills introduced in the 2018 session 

sought to gut RSA 200:29, by eliminating 

NEW HAMPSHIRE 

VETERANS HOME 

POSITIONS AVAILABLE 

Psychiatric Nurse Practitioner 

$71,988.80- $98,321.60 

Registered Nurse I/II/III 

$49,316.80 - $78,478.40 

Additional $.50/hr Direct care pay Plus an 

additional 15% enhancement of base pay 

approved by Governor and Council 

For Further Information 

Please contact Karen Norris, Assistant Nursing 

Director at (603) 527-4431, submit an application to 

Careers@nhvh.nh.gov or mail to 

139 Winter Street, Tilton, New Hampshire 03276. 

http://das.nh.gov/jobsearch/Employment.aspx 

all requirements for school nurses except a 

registered nurse license. House Bill 1217 

was passed on February 22, 2018. The 

comparable Senate Bill 434 was reviewed 

by the Senate Education Committee 

on April 3 with a vote of “ought to 

Pass.” However, on April 12, the full 

Senate failed to pass, effectively 

killing the bill for this session. 

The school nurse certification 

requirements will remain as 

voted in 2016. 

Kudos to the Commission on 

Government Affairs, and chair, Pam 

DiNapoli for their tireless work to defeat this bill. 

Are you an experienced RN tired of working weekends, various 

shifts, and holidays? Do you desire more autonomy and flexibility? 

Lakes Region Community Services (LRCS) has an immediate 

opening for a full time Registered Nurse in supporting 

our individuals with developmental disabilities 

and/or acquired brain disorders. 

Monday - Friday 1st shift schedule • Generous benefit package. 

This position involves training and monitoring of staff and 

providers in all aspects of health care coordination and medication 

administration under HeM-1201. Two years’ experience as an 

RN required preferably in the areas of developmental 

disabilities, home health, or hospital care. 

Valid NH RN and driver’s license required. 

Please visit www.lrcs.org to apply.


In the next three months over 

500 new nurse graduates 

will experience the anxiety, 

stress, fear, sweaty palms 

and palpations induced 

by sitting for the NCLEX in 

order to obtain a nursing 

license. Hopefully they have 

learned that the license is 

their passport to a career that 

is abundant in opportunities 

and career choices. A license 

that should be protected at all 

Susan Fetzerr 

times with careful practices 

and adherence to standards of care. A license that is 

a privilege, granted by the state who is charged with 

guarding the health of their citizens. Along with a license 

comes the privilege of proclaiming yourself a nurse, a 

protected title. When you proclaim yourself a nurse, and 

are hired to practice as a nurse, there are expectations. 

Expectations that you will act as a professional and 

uphold the Code of Ethics. 

So, I find it incredulous that Lakes Region General 

Hospital hired Patricia Strohla, of Brownsville, Vermont, 

in November 2016. Strohla came to Laconia from Mount 

Ascutney Hospital and Health Center in Vermont, 

where she spent the past four years working with Kevin 

Donovan, who was appointed president and Chief 

operating officer of LRGH earlier in 2016. At Mount 

Ascutney, she held non-nursing positions, including 

director of clinical transformation within the department 

The following practice inquiries were answered by 

the New Hampshire Board of Nursing during the first 

quarter of 2018. 

Question: Can LNA’s provide colostomy care to a 

stable client in long term care, home or residential 

facilities? 

BON: It is within the scope of LNA practice 

to provide colostomy care to a stable client in 

LTC, home and residential facilities if the LNA is 

trained and exhibits competence. 

Question: Is it within the scope of LPN practice 

to perform the tasks related to the care the Pleurex 

system on stable clients that do not need a 

comprehensive assessment of their health status? 

BON: With appropriate training and competency, 

providing care for clients requiring Pleurex 

intervention is within the scope as long as 

the client is stable and does not require a 

comprehensive health assessment. 

Question: Are the following procedures within 

the scope of practice for an LNA working in the 

Emergency Department? 

1. Hold for Lumbar puncture, if so what age 

group? 

BON: Holding a client for a lumbar puncture 

would be a task not a skill, and that with 

training an LNA could perform this task. Ages 

of clients would not affect the ability of the 

LNA to assist with holding a client as directed. 

An institutional policy should be in place. 

2. Obtain oral, axillary and rectal temperatures. 

BON: These tasks are taught in LNA programs. 

3. Perform a Breathalyzer test. 

BON: LNA’s can be trained to perform 

Breathalyzer with appropriate training and 

institutional policy guidelines. 

IN MY OPINION 

What Was She Thinking? 

of quality and directly supervised the information 

technology team. According to New Hampshire Senior 

Assistant Attorney General James Boffetti she did not 

hold a nursing license in Vermont, and a previous license 

in Maine expired in 2005. 

A June 2017 citation from the Centers for Medicare 

and Medicaid Services stated that LRGH hired Strohla 

knowing that she did not hold the required nursing 

license. New Hampshire Attorney General Gordon 

MacDonald noted that LRGH identified Strohla as a 

registered nurse on its website and on her employee 

badge. Strohla also identified herself as a registered 

nurse in documents she signed as the chief of nursing. 

The NH Attorney General alleged that LRGH improperly 

modified Strohla’s job description to allow her a oneyear 

grace period to obtain her license. Following the 

CMS citation in August 2017, Strohla was reassigned to 

serve as interim vice president of operations. She left 

LRGH in January, 2018. 

Though the State alleged that both Strohla and LRGH 

participated in unfair or deceptive business practices in 

violation of the Consumer Protection Act, both parties 

denied the allegations. In reaching an agreement LRGH 

agreed not to employ anyone as CNO unless that person 

possesses an active New Hampshire nursing license or is 

otherwise qualified to hold that position under applicable 

laws and verify that all of its employees who are engaged 

in the practice of nursing have an active New Hampshire 

nursing license. LRGH is required to pay $40,000 to the 

State in the settlement. Strohla agreed that she will not 

News 

Question: With a provider order, is it within RN/ 

LPN scope of practice to mix/draw up lidocaine, 

depomedrol or Marcaine for intra articular injector 

used by the provider? 

BON: It is within scope of RN/LPN to mix and 

draw up medications, with a provider order and 

advises the following situations for use: 

- During an emergency situation in an 

operating room or treatment room, a nurse 

working in the same room, at the same time, 

attending the same patient may collaboratively 

prepare an injection for immediate patient 

administration. 

- Communication between the provider and 

nurse should occur regarding validation of 

the integrity of the medication, and dosing 

as indicated by the medication order. 

Documentation should be completed in 

accordance with organizational policies. 

Question: With a provider order, is it within the 

scope of practice of an RN/LPN to apply fluoride 

varnish to the teeth of a pediatric patient as part of 

the primary care office visit? 

BON: It is within scope of RN/LPN to apply 

fluoride varnish to teeth with a provider order 

and appropriate training and competency. 

seek licensure in any form from the New Hampshire 

Board of Nursing for two years and will pay $1,500 to 

the State. 

I wondered to myself: What was she thinking? Over 10 

years without a nursing license, and still calling yourself 

a nurse? Over 10 years without a nursing license and 

thinking you could get a new license in a year? Over 10 

years without a nursing license and no one else cared 

to ask or question? When I first heard of this story, I felt 

saddened, dismayed, and disappointed. Imposters and 

frauds don’t belong in nursing when we are considered 

the most “trusted” profession. I hope Strohla finds 

another job, more fitting. 

But mostly, my sympathy goes out to the trusting nurses 

of LRGH. In my opinion they deserved a better leader. 

Their new CNO has a mighty challenge. 

NURSES 

ON THE MOVE 

Theresa L. Champagne, RN, DNP, CNOR has been 

appointed Chief Nursing Officer at Lakes Regional 

Hospital. Champagne will replace Kendra Peaslee, 

RN who has been serving as the Interim Chief Nursing 

Officer. Champagne was formerly the Associate 

Chief Nursing Officer of Surgical Services for Vassar 

Brothers Medical Center-Poughkeepsie, New York. 

She holds a Bachelor of Science in Nursing from St. 

Anselm’s, a Master of Science in Nursing with focus as 

a Clinical Nurse Specialist from Western Connecticut 

State University and a Doctor of Nursing Practice from 

Oakland University, Rochester, Michigan. 

Prior to her role at Vassar Brothers Medical Center, she 

spent four years as the Director of Perioperative Services 

at Western Connecticut Health Network in Danbury, 

Connecticut. Champagne also spent 28 years at Danbury 

Hospital in Danbury, Connecticut serving in several 

nursing roles. 

* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * 

Jean Coffey, RN, PhD, PNP has assumed the Director of 

the Nursing program at Plymouth State College replacing 

retiring Director Dr. Kathleen J. Patenaude. Coffey holds 

a ASN from the University of Vermont, a BSN from 

Norwich University, MS in Community Health Nursing 

from the University of Vermont and PhD in Nursing from 

the University of Connecticut. Her teaching, research 

and clinical work focuses on children and families’ 

health care needs. She has worked as a clinical instructor 

and assistant professor in undergraduate and graduate 

nursing and programs at several universities throughout 

the northeast. For the past 3 years she has been the 

Director of Research and Education at Dartmouth 

Hitchcock Medical Center. 

NursingALD.com can point you 

right to that perfect NURSING JOB! 

NursingALD.com 

Free to Nurses 

Privacy Assured 

Easy to Use 

E-mailed Job Leads


95 senior nursing majors received their Saint Anselm College nurse's 

pin at the annual pinning ceremony April 25 in the Abbey Church 

The University of New Hampshire graduated five new Doctors of 

Nursing Practice (DNP) at the May 18 Commencement. 

Dr. Pam Kallmerten and Dr. Patti Puccilli were 

recently promoted to clinical associate professors at 

the University of New Hampshire. 

All 12 of Colby-Sawyer’s first cohort of Master of Science in Nursing (M.S.N.) 

students passed the Clinical Nurse Leader (CNL) certification exam on their first 

attempt. Colby-Sawyer launched the 37-credit graduate program in fall 2016. 

The first class are employed at Dartmouth-Hitchcock Medical Center (DHMC). 

(L-R) Drs. Emily Jenkins Bombard, Kimberly Gibbons, 

Amanda-Jon Garcia, Sarah Wahl and Marcy Doyle. 

ED Note: News from nursing schools, faculty, students or alumni are welcome. 

Please direct submissions to office@nhnurses.org with NHNN in the subject line.


WELCOME NEW and RETURNING NHNA MEMBERS! 

NHNA welcomes these new and returning members. Thank you!!! 

What do these 64 nurses know that you don’t? If you are not a member ask someone on this list why they joined! 

Go to nhnurses.org where joining is easy and one of the best professional values for your money! We want to see your name here in the next issue of the NH Nursing NEWS! 

Alton, NH 

Amy Tremblay 

Barnstead, NH 

Ramona McConville 

Bedford, NH 

Annie Galeucia 

Bennington, NH 

Lisa Foote-Fyfe 

Bethlehem, NH 

Kristianne Pinard 

Bow, NH 

Laura Dewar 

Bristol, NH 

Patricia Perreault 

Brookline, NH 

Jennifer Alexander 

Kristyn Ferrelli 

Center Barnstead, NH 

Rosemary Costanzo 

Deerfield, NH 

Jennette Wolfgram 

Dover, NH 

Delores Richardson 

Durham, NH 

Katherine Meredith 

Tamer Osman 

Exeter, NH 

Nicole Lincoln 

Gilford, NH 

Jennifer Jude 

Gorham, NH 

Carolyn Drouin-Wood 

Hancock, NH 

Anne Peirce 

Hanover, NH 

Nina Lloyd 

Harrisville, NH 

Melody Moschan 

Holderness, NH 

Kim Johnstone 

Kerriann Reynolds 

Hollis, NH 

Patricia Lazare 

Hooksett, NH 

Michelle Smith 

Hopkinton, NH 

Patricia Fuller 

Hudson, NH 

Julie Woods 

Laconia, NH 

Kaitlynn Liset 

Lebanon, NH 

Amanda St Ivany 

Roxanne Taylor 

Lee, NH 

Alana Patterson 

Litchfield, NH 

Mary Geist 

L Pacheco 

Londonderry, NH 

Marilyn Daley 

Cara Hartigan 

Megan Whiteneck 

Lyman, NH 

Mary VanAlstyne 

Manchester, NH 

Delia Considine 

Catherine Cuchetti 

Emily Harrises 

Erin Maguire 

Mary Petty 

Tayla Trask 

Nikki Wells 

Meredith, NH 

Mouse McLeod 

Merrimack, NH 

Beth Joseph 

Christine Kociszewski 

Melinda Noel 

Milford, NH 

Ashley Triehy-Kreitler 

Milton, NH 

September Major 

Nashua, NH 

Linnea Barnard 

Sarah Blanchette 

Heidi Coen 

Tamara Tello 

Shanan Williams 

Newport, NH 

Pamela Carley 

Pembroke, NH 

Gail Pritchard 

Kaleigh Reagan 

Peterborough, NH 

Samantha Bernstein 

Rumney, NH 

Jennifer Miller 

Sunapee, NH 

Arlene Halsted 

Tilton, NH 

Alicia Nerich 

Weare, NH 

Rosanna Dinan 

Katelyn Jerry 

Wilton, NH 

Virginia Tuttle 

American Academy of Ambulatory Care Nursing 

in New Hampshire 

On March 24, 2018 approximately 140 ambulatory 

care nurses gathered at the Puritan Back Room for the 

First Annual Ambulatory Care Conference. Dartmouth- 

Hitchcock sponsored this event, which was opened 

by Joni Spring, Director of Outpatient Nursing & The 

Jack Byrne Center for Palliative and Hospice Care 

at Dartmouth Hitchcock Medical Center. Spring 

introduced the keynote speaker, Susan Paschke, a 

member of the Faculty at Kent State University in Ohio 

and past President of the AAACN. Ms. Paschke spoke 

about advancement of the ambulatory care nurses role 

over the past few decades. 

The American Academy of Ambulatory Nursing 

Administration was founded in 1978 as a not for 

profit, educational forum. In 1993, the organization 

changed its name to the American Academy of 

Ambulatory Care Nursing (AAACN). Membership 

was expanded to include nurses in clinical practice, 

education, and research roles as well as those in 

management and administration. AAACN is the 

only specialty nursing association that focuses on 

excellence in ambulatory care; however, it is not yet a 

nursing specialty recognized by the American Nurses 

Association. The mission of the AAACN is to advance 

the art and science of ambulatory care nursing. In 

2011 the AAACN published it’s first-ever position 

statement regarding the role of the registered nurse in 

ambulatory care (AAACN, 2017). 

After Ms. Paschke’s opening remarks, the nurses 

broke into facilitated focus groups to discuss topics of 

interest for ambulatory nurses, including topics such as 

onboarding, orientation, care coordination, caring for 

the patient in the ambulatory setting, and professional 

development of the ambulatory nurse. The program 

then moved from discussion to actions with the 

development of ambulatory special interest groups, led 

under the direction of Ms. Paschke. 

After lunch-time networking and visits with exhibitors, 

the nurses listened to a presentation by Honorable 

John T. Broderick Jr., former Chief Justice of the NH 

Supreme Court and Dean of the University of New 

Hampshire School of Law. Judge Broderick spoke on 

Mental Health Issues Concurrent to Opioid Addiction. 

RN to BSN 

Fully Online 

Program 

courses offered in 6-week 

accelerated sessions 

844-944-TAWC 

baypath.edu/nursing 

Finally, Cynthia O’Donnell, Clinical Nurse Supervisor, 

Pediatric Gastroenterology with Dartmouth- 

Hitchcock, moderated a panel to discuss the Opioid 

Crisis and the Rise in NH Grand families and the 

unique challenges and health implications that every 

nurse should know. 

Reference: 

AAACN. 2017. American Academy of Ambulatory Care 

Nursing Position Paper: The Role of the Registered Nurse 

in Ambulatory Care. 

All nurses are eligible for a minimum of 30 transfer credits, and possibly up to 84 towards their degree. 

ACCREDITATION STATUS, The Bachelor of Science in Nursing at The American Women’s College of 

Bay Path University is accredited by the Commission on Collegiate Nursing Education, 655 K Street, 

NW, Suite 750, Washington, DC 20001, 202-887-6791. (http://www.ccneaccreditation.org)


Students listening to Bobbie Bagley, Director 

of the Nashua Dept of Public Health & 

Community Services and NHNA Immediate 

Past President, speaking on the Role of 

Professional Organizations and Advocacy. 

The New Hampshire Nurses Association’s (NHNA) 

Commission on Nursing Practice (CNP) and co-host 

Southern New Hampshire University (SNHU) conducted 

another successful Student Nurse Conference! On 

March 27th, 170 students from the University of New 

Hampshire, Colby-Sawyer College, Rivier University, 

Nashua Community College, New Hampshire Technical 

Institute, Manchester Community College, Plymouth 

State University, St. Anselm College, St. Joseph School 

of Nursing, and White Mountain Community College 

attended this year’s 4th Annual NHNA Graduating 

Student Conference. The day was jammed packed 

with several guest speakers covering a variety of topics 

which focused on The Nursing Workforce, Nursing 

Career Paths & Education, Protecting Your License, Role 

of Professional Organizations & Advocacy, Surviving 

and Thriving your Job Search, and NCLEX Prep for 

Success. Additionally, the conference offered open 

panel discussions with representation from specialty 

Registered Nurses and New Graduate Nurses. There 

2018 Graduating St 

were 24 exhibitors and sponsors present, which gave 

the students an opportunity to learn more about each 

of their organizations. Exhibitors included: LRGH, Hurst 

Communications, Rivier University, St. Anselm College, 

Granite State College, RiverWoods, NH Hospital, 

Bedford Nursing & Rehabilitation Center, Visiting Nurses 

Association Health Systems of Northern New England, 

Concord Hospital, Dartmouth-Hitchcock, Eastern Maine 

Health Systems, Brattleboro Retreat, Speare Memorial 

Hospital, Navy Recruiting of New England, and Saint 

Joseph Hospital. 

The NHNA and SNHU would like to recognize the event 

Gold Sponsors: Elliot Health Systems, Southern New 

Hampshire Health Systems, Catholic Medical Center, 

North Country Healthcare, Nurses Service Organization 

(NSO), and the Silver Sponsors: Cheshire Medical Center 

and the University of Rhode Island for their support in 

sponsoring this annual event. 

Topping off the packed conference day the NHNA 

CNP honored two student nurses that demonstrated 

all the finest nursing qualities: caring, professionalism, 

advocacy, leadership, and involvement. This year the 

competition was fierce. The first runner-up was awarded 

to Meghan Livingston, a senior in the nursing program at 

Plymouth State University. The Student Nurse of the Year 

was awarded to Hannah Glover, a senior nursing student 

at Saint Anselm College. Congratulations to the recipients 

and nominees of this prestigious recognition. 

Students networking and speaking with 

exhibitors, Bedford Nursing & Rehab and VNA 

Health Services of Northern New England in 

the background. 

Mike Rennie and Dennis Denirovic of Southern 

NH Medical Center, a Gold Sponsor, speaking 

with students. 

This year the conference delivered high-quality content 

which educated students about the current New 

Hampshire healthcare issues, along with providing 

helpful tips to prepare for their transition into nursing. 

Feedback from the attendees and exhibitors was that 

the conference was an invaluable experience. The CNP 

looks forward to planning next year’s student nurse 

conference and supporting the ongoing efforts of the 

NHNA in advancing nursing practice. 

Matt Mannarino of Cheshire Medical Center, 

a Silver Sponsor. 

Members of the Specialty Nurse Panel, Captain 

Jody Bell, USN, Darlene Morse, DHHS Bureau of 

Infectious Disease Control, Bonnie Crumbley-Aybar, 

Board of Nursing, Linda Goldthwaite, Aurora Senior 

Living and Chelsea Cahill, Dept of Corrections. 

Jane Delmar, Catholic 

Medical Center, a Gold 

Sponsor, speaking on 

Surviving and Thriving 

your Job Search. 

Pam Kallmerten, 

UNH and NHNA 

Board Member 

speaking on NCLEX 

Prep for Success. 

Student Conference – Front Row Seat 

The presentation I found most helpful at the 

NHNA conference was the Registered Nurse panel 

comprised of a nurse who is in the United States 

Navy Reserves, a Public Health Nurse, a Post 

Anesthesia Care Unit Nurse, an RN in long-term 

care, and a 2014 graduate working as an RN at the 

New Hampshire Correctional Facility for Women. 

The nurse in the Navy detailed how her job allows 

her to invest in the art and science of nursing while 

serving the country at the same time, no matter what 

country she goes to. She spoke of balancing work 

life with family life and the challenge that poses. The 

public health nurse said she never thought of being 

a public health nurse, and frankly did not know 

much about public nursing before working for the 

state. It took her about a year to get “up to speed” 

on infectious diseases and she is now an advocate for 

laws and policies in New Hampshire. She stated that 

politics are often the hardest part of public health 

nursing, and there isn’t always a change in legislature 

until the public health issue directly affects one of the 

politicians’ homes. 

The PACU nurse explained that she wears a “dual hat” 

as she is an actively practicing RN, and a professor. 

As a professor she has been collecting data on the 

performance of nursing students in hopes of identifying 

how curriculum can be improved. She recommended 

keeping one foot in the door at the hospital and working 

per diem when perusing a career outside of direct care. 

The long-term care nurse began at Concord Hospital’s 

diploma school of nursing and had the opportunity 

to open a cardiac specific floor after graduating. After 

years of practice she decided she wanted a family and 

children and moved into family practice. From there 

she moved to long-term care and has been there for 

20 years. She spoke of the stigma that long-term care 

holds, specifically nursing homes, and how the growing 

over 65 year old population will make long-term care 

increasingly important in upcoming years. The final 

nurse on the panel, a 2014 graduate working at the 

department of corrections, spoke of how she always 

thought she would end up in the hospital, however the 

opportunity at the correctional facility presented itself 

and she loves her job. She detailed the importance of 

a team approach with security, working to develop a 

safe yet therapeutic environment, a balance that is often 

hard to create in this setting. 

The takeaway I had from this panel was that there is 

such a wide variety of opportunity to pursue with this 

degree. Similar to the nurse working in the department 

of corrections, I have always thought of beginning 

my career in the hospital on a medical-surgical floor, 

however, I have recently become open to the idea 

of starting my career path in a different care setting. 

Each member of the panel holds different experiences 

and has taken a different path to the position they 

currently hold. This illustrates how I could end up in 

a completely different care setting than that I begin 

with. I found the NHNA conference benefitting. It was 

a great opportunity to hear advice and experiences 

from other nurses and to network with numerous New 

Hampshire hospitals. 

— Cameron Patridge, Conference Attendee, 

BSN, 2018


udent Conference 

Each spring, the New Hampshire Nurses Association 

Annual Awards Program provides a prestigious 

opportunity to recognize outstanding performance of a 

student nurse. The “Student Nurse of the Year Award” 

is selected based on nominations submitted to the 

NHNA Commission on Nursing Practice. 

This award is given to a student nurse in an entry 

program who embodies all the finest qualities of 

nursing: caring, professionalism, advocacy, leadership 

and involvement. 

2018 Student Nurse of the Year Award 

The NHNA Commission on Nursing Practice reviews 

letters of nomination for this prestigious award, which 

identify evidence of caring, professionalism, advocacy, 

leadership and involvement. The nominations for 2018 

were highly competitive. 

The First runner-up is conferred to Meghan Livingston 

a senior in the nursing program at Plymouth State 

University. Meghan was described as an exemplary 

student at Plymouth State University and a leader 

among her peers. She is a great advocate for the 

vulnerable and underserved mental health and 

substance abuse populations. A major interest of hers is 

patients with eating disorders. She took a graduate level 

course in this subject in order to better care for these 

special people. 

During her time at Plymouth State Meghan also 

served current and future students by working in 

the office of Academic Affairs. In addition to her 

rigorous undergraduate coursework, her job and 

her extracurricular sports activities, Meghan was 

described as a generous volunteer. She has been an 

active member of the Student Nurses Association. She 

performed public mental health screenings and was 

involved in numerous public service projects with her 

church. She is driven by a desire to serve. 

In recognition of her work, Meghan is being 

awarded with a one year membership to the NHNA. 

Congratulations Meghan. 

Hannah Glover, Saint Anselm College, accepting 

Student Nurse of the Year Award from Jennifer 

Johnson, Chair of NHNA's Commission on 

Nursing Practice. 

This year, the Commission on Nursing Practice is pleased 

to honor Hannah Glover, a senior nursing student at 

Saint Anselm College, as recipient of the “Student Nurse 

of the Year” award. 

Hannah is described as being inspirational demonstrating 

unparalleled compassion and academic ambition, while 

exuding grace and fortitude to both her peers and 

patients. Hannah demonstrates the five key attributes 

that this award symbolizes: caring, professionalism, 

advocacy, leadership and involvement. 

This past summer Hannah was working as a home 

healthcare aide. Hannah went above and beyond to 

advocate for her homebound immunocompromised 

patient who desired an outdoor shopping trip. Knowing 

that her patient could not leave the house, Hannah 

went above and beyond reaching out to the agency 

and a local boutique arranging a home shopping day. 

Hannah was also selected by her faculty to participate 

in a summer preceptorship at Tufts Medical Center on a 

cardiomyopathy unit. 

Meghan Livingston, Plymouth State University, 

the Student Nurse of the Year, First Runner Up 

Last year, Hannah spent time in Costa Rica assisting 

medical clinics and performing home care visits with 

the local healthcare staff. This experience expanded 

Hannah’s cultural competence and awareness, which 

she was able to carry forward in her own nursing care. 

Hannah serves as a clinical leader to the 

underclassman during their ICU rotations. In addition, 

she wrote an article titled “Preserving Hope,” which 

was accepted by Imprint, the professional magazine 

for student nurses produced by the National Student 

Nurses Association. It is anticipated to be published 

this spring. Hannah is also an active member of the 

Oncology Nursing Society, Saint Anselm’s Student 

Nurse Association, Co-chair of the Nursing Pinning 

Ceremony Committee, and she volunteers as at Saint 

Anselm’s Open House Student Panel. She does all of 

this while she continues to work as nursing assistant in 

an emergency department. 

Submitted by Jennifer Johnson, Chair Commission on 

Nursing Practice and MaryEllen King, member of the 

Commission on Nursing Practice 

Dear Friends, 

March 27, 2018 

I regret that I cannot be with you, but I would like to welcome all of you to the New 

Hampshire Nurses Association Graduating Student Conference and Career Fair, and 

to congratulate all of the nursing students here today on your upcoming graduation. 

Nurses are critical to the health and well-being of our people and are vital 

components of our health care industry. You have all worked hard to develop the 

skills that will help Granite Staters achieve better health, and I commend you all 

for your commitment to their well-being. As the national health care workforce 

shortage continues to threaten our ability to meet the health care needs of our 

citizens, your commitment to a career in nursing is even more critical, helping to 

make a real difference in the lives of countless Granite Staters and for the future 

of our state. 

I want to thank the New Hampshire Nurses Association for organizing today's 

conference and your year-round support of nursing professionals across our state. 

By working to strengthen the nursing profession in New Hampshire, your efforts 

go a long way toward ensuring that we have the nurses – and that our nurses have 

the resources – needed to ensure that we can maintain a healthy and productive 

citizenry and workforce that is necessary to a thriving economy and democracy. 

Once again, congratulations to all the nursing students here today on your upcoming 

graduation, and thank you for your dedication to the health of your fellow citizens 

and our state's future success. I look forward to working with you to support your 

hard work and help build and sustain a strong, healthy New Hampshire. 

With every good wish, 

Margaret Wood Hassan 

United States Senator 

Are you ready to advance 

in Nursing Practice? 

Check out your options right here at UNH: 

Graduate Program in Nursing (Master of Science Degree) 

Post-Master’s Family Nurse Practitioner Certificate Program 

Post-Master’s Psychiatric Mental Health Nurse Practitioner 

Certificate Program 

Doctor of Nursing Practice 

For more information about UNH Nursing 

www.chhs.unh.edu/nursing


NCLEX Reconsidered 

Ed Note: Where it has been a year 

or years since you took the NCLEX 

(AKA “Boards”), how well would 

you do now? 

1. When developing the plan of 

care for a multigravida client 

with class III Heart Disease 

which of the following areas 

should the nurse expect to 

assess for frequently? 

a. Fluid volume status 

b. Nausea and vomiting 

c. Iron-deficiency anemia 

d. Tachycardia 

2. After a bilateral adrenalectomy for Cushing’s 

disease, the client will receive periodic testosterone 

injections. The expected outcome of this therapy is: 

a. Balanced reproductive cycle 

b. Restored sodium/potassium balance 

c. Stimulated protein metabolism 

d. Stabilized mood swings. 

3. Which assessment findings should lead the nurse 

to suspect that a toddler is experiencing respiratory 

distress? (Select all that apply) 

a. RR = 35 bpm 

b. HR = 95 bpm 

c. Restlessness 

d. Malaise 

e. Diaphoresis 

Rebeca Roma, RN, BSN, recently returned to her 

position at Catholic Medical Center after working aboard 

the floating hospital Africa Mercy, off Africa’s coast with 

an all-volunteer medical staff for two months. Roma’s 

unit treated facial abnormalities. “Some patients, it was 

just one little tear. Other patients, it was shouting for 

joy and lifting their hands in the air and shouting and 

praising God,” Roma said. Roma used vacation days 

and took a leave of absence from her job to make the 

trip. “It was a life-changing experience. I think I saw and 

witnessed what true suffering is and also what true joy 

is,” Roma said. 

* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * 

Susan Kinney, MSN, Director of the St. Anselm College 

RN to BSN program has been appointed to a 3 year term 

on the Catholic Medical Center Board of Directors. 

* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * 

Kudos to Gail Thomas, RN, Cheshire’s Keene Sentinel 

2018 Reader’s Choice award for Best Local Nurse. 

* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * 

Congratulations to Julie Patrikas who won two tickets 

to the Red Sox Nurse Appreciation Night game in the 

NHNA drawing. 

4. Which of the following physiologic responses 

should the nurse expect as unlikely to occur when a 

client is angry? 

a. Increased respiratory rate 

b. Decreased blood pressure 

c. Increased muscle tension 

d. Decreased peristalsis 

5. The nurse is caring for a client with a spinal cord 

injury. The client is experiencing blurred vision and 

has a blood pressure of 204/102. What should the 

nurse do first? 

a. Position the client on the left side 

b. Control the environment by turning the lights off 

to decrease stimulation 

c. Check the client’s bladder for distention 

d. Administer blood pressure medication 

New Hampshire Workforce Numbers 

1,728 PROJECTED NEW JOB OPENINGS BY 2024 

9.3% % JOB GROWTH 

1,921 OVERALL PROJECTED GAP 

The future composition of New Hampshire’s 

healthcare workforce depends on what’s 

happening in Boston to 

the south. The largest 

increases in demand for 

healthcare labor across 

Greater Boston are 

expected not in Boston 

itself but in surrounding 

communities—especially 

New Hampshire where 

the current supply of some critical occupations 

is especially low. This not only places supply 

pressures on healthcare talent in the southern 

part of the state; it also creates challenges for 

north New Hampshire as well. Filling critical 

roles in more remote parts of the state is a 

challenge, and this is unlikely to change in the 

near term. The opioid epidemic is also a major 

concern in New Hampshire, and while it’s 

difficult to project the direct impacts of this 

epidemic on future healthcare labor demand it’s 

very likely that healthcare systems will need to 

change their workforce to address this crisis. 

Source: https://mercer.healthcare-workforce.us/ 

Answers can be found on page 16 

White River Junction, VT VA Medical Center 

is seeking experienced Nurses for the following clinical areas: 

Med/Surg • Dialysis • OR • ED • ICU 

Same Day/PACU • Mental Health • Nurse Manager (Med/Surg) 

RN (subspecialty) • Chief Nurse on Duty (CNO) 

Join our team and receive excellent benefits including: 

• 26 annual and accruable paid vacation days 

• 13 annual and accruable sick days 

• 10 paid Federal holidays 

• Retirement thrift savings plan with matching dollars 

• Tuition reimbursement after one year of 

employment for qualified employees 

I’m not just a nurse. 

I’m inventing a new 

model of health care. 

To learn more contact regina.radikas@va.gov 

Equal Opportunity Employer 

Amy, VA RN


From the Bookshelf Movies 

Stories That Teach a Lesson 

Anita Pavlidis, MS, RN 

Story telling is as old as mankind and describes the 

social and cultural activity of sharing stories, sometimes 

with improvisation, theatrics, or embellishment. It’s a 

means of sharing and interpreting experiences. Every 

culture has its own stories or narratives, which are 

shared as a means of entertainment, education, cultural 

preservation or instilling moral values. Crucial elements 

of stories and storytelling include plot, characters and 

narrative point of view. Other than the traditional oral 

storytelling and written word, new forms of media are 

creating new ways for people to record, express and 

consume stories. Only the medium has evolved over 

time and nowadays, stories are told in all mediums and 

places. 

The Oscars have been a way to honor and reward those 

who are exceptionally good at telling stories using film 

as their medium. Prior to the awards show, I had the 

pleasure of seeing the Oscar Shorts, specifically the 

animated films. They portrayed the reality of life’s joys, 

laughter, and adventure told thru the lens of the worlds’ 

best Oscar nominated animated short films. There were 

five “shorts” that ran anywhere from 5 to 29 minutes. 

They maybe “short” on time but long on substance. 

Dear Basketball is a short film that explores what it 

means to achieve your dream and then leave it behind. 

The animated film is an adaptation of Kobe Bryants’ 

NBA retirement announcement after 20 years with the 

Los Angeles Lakers. Narrated by Bryant, the animated 

film and emotional score touches fans of all ages with its 

universal message about love and loss. It’s unexpectedly 

moving. 

The Hollywood Reporter explores the Garden Party 

which moves into darker territory. In seven, wordless, 

minutes, dozens of frogs explore an abandoned rich 

house. There some indelible images, from a frog 

climbing across a window, to a large amphibian caught 

in a jar or sticking its face in a pile of caviar. The 

villa seems to have been abandoned under violent 

circumstances, if the bullet holes through the walls are 

any indication. Initially, a playful scene, but when one of 

the animals accidentally activated the pool area’s lights, 

a gruesome discovery emerges, a somewhat disturbing 

end. 

Lou tells of a school yard where a toy stealing bully runs 

recess for a playground full of kids; only one thing stands 

in his way, the “Lost & Found” box. The story tells of a 

stereotypical bully and builds a back story, a moral tale, 

and a righteous end, all based on the mystery of the title. 

The Boston Globe defines it as a charming and rather 

bizarre tale in which the contents of a schoolyard lost 

and found bin animate into a creature bent on teaching 

life lessons to a bully that sharing is caring. 

Martha Baker of KDHX honors one of the most touching 

shorts, Negative Space. It is an adaptation of a poem by 

Ron Koertage about a son and father bonding through 

a perfectly packed suitcase starting with an opening 

statement of “My dad taught me how to pack.” Gary M. 

Kramer of http:// filmint.nu writes that this slight entry is 

the most melancholy. This nominee uses stop motion 

and showcases some nifty visual motifs- a road becomes 

a zipper, signaling a memory or wave of clothes “wash“ 

up and across a floor as a son recalls the bond he had 

packing suitcases with and for his father. Tom Long 

of the Detroit News aptly describes it as a film with 

an underlying sadness balanced by a faith in order. 

Although the end is obvious, the short is quite touching. 

Revolting Rhymes, was the longest of the nominees 

lasting 30 minutes. Gary Kramer accurately describes 

it as a revenge filled tale that interweaves Roald 

Dahl’a retelling of classic fairy tales with playful twists 

and surprising endings. A wolf recounts the ill-fated 

encounters of his two nephews each had when they met 

Red Riding Hood. Snow White, Grandma, seven jockeys 

(dwarfs!), a wicked queen and a magic mirror among 

other fairy tale favorites figure prominently in the story. 

The longer short is witty and clever, meant to amuse 

both children and adults. Alas, I was not amused so 

much as disturbed by the dark ending. 

In case you are wondering, the winner for the Oscar 

for Best Animated Shorts was Dear Basketball. A good 

choice but Negative Space won my vote for best short. 

Anita Pavlidis, RN MSN was the former Director of 

Nursing at the NHTI, Concord’s Community College 

and Program Specialist at the New Hampshire Board of 

Nursing. 

A Nurse’s Role in the Legislative Process 

The motion on the table was that HB 1822 ought to pass, 

as moved by Senator Martha Hennessy and seconded by 

Senator Kevin Avard. The Bill: An ACT making hormonal 

contraceptives available directly from pharmacists 

by means of a standing order. Before polling for the 

final vote, Senator Jeb Bradley paused to comment on 

the process through which this bill came into being, 

commenting that this bill is an example of how a 

legislative commission should work. 

In 2017, with the passage of House Bill 264, a 

Commission was established “to study allowing 

pharmacist to prescribe or make available via protocol 

oral contraceptives and certain related medications.” 

This 19-member Commission was comprised of 

pharmacists, nurses, nurse practitioners, physicians 

and organizational experts in the field of women’s 

health, as well as appointed legislators (see list). The 

Commission met between September and November 

of 2017. The Commission members reviewed other 

state experiences with pharmacists’ use of standing 

orders or protocols in the dispensing of hormonal 

contraceptives. The evidence was reviewed, options 

were explored and deliberations were lengthy. A final 

report was submitted to the Governor, and House and 

Senate Leadership on December 1, 2017. This report, 

and the recommendations contained in the report had 

received the unanimous approval of the 19 members of 

the Commission. The outcome of the work was House 

Bill 1822. In addition, a companion Senate Bill, 421, 

(An ACT relative to insurance coverage for prescription 

contraceptives) was also unanimously endorsed. 

“The commission was diligent in its work; the 

experts on the commission brought their experience, 

knowledge and expertise to the table and worked 

through a myriad of issues successfully. The roll call 

vote at the end of our work, 17-0 with three people 

absent, was a true testament to the hard work and 

diligence that exemplified this commission. There was 

always a common thought of wanting to bring about 

good legislation while responding to the needs of the 

constituents while not trampling on the responsibilities 

of all of the providers. As the Chair of this Commission, 

it was my sincere honor and pleasure to work with 

each and every member and to bring about a Bill that 

truly supports a woman’s right to have easier access to 

hormonal contraceptives,” (Personal communication, 

Rep. Mariellen MacKay, May 1, 2018). 

Since the conclusion of the Commission, some members 

have worked over the past few months to secure the 

passage of these bills, providing testimony at numerous 

public hearings and answering legislators’ questions. 

Sara Kellogg Meade, MS, RN was NHNA’s designated 

appointee to the original Commission in 2017. Sara 

is a member of New Hampshire Nurses Association 

(NHNA) and a participant on NHNA’s Commission of 

Government Affairs as a representative of AWHONN 

(Association of Women’s Health, Obstetric and Neonatal 

Nurses). 

Sara has testified before the House Committee on 

Health, Human Services and Elder Affairs and the 

Committee on Commerce and Consumer Affairs, as 

well as the Senate’s Committee on Commerce and most 

recently, the Senate Committee on Health and Human 

Services. In planning for each testimony, she drafted a 

statement, making 2-3 main points. She was supported 

in this work by the leadership of NHNA, who provided 

guidance and insight. She then presented concise 

testimony outlining the benefits of this legislation and 

the consequences of failure to pass it. She has answered 

many questions of the legislators, explaining, in lay 

language, the risks and costs of unplanned pregnancy 

and the role that access to oral contraceptives plays in 

reducing unplanned pregnancies. 

Throughout the process, Sara has relied on her nursing 

experience in maternal and child health, sharing her 

first-hand experience with legislators in ways that they 

can readily understand. Sara has realized through 

this experience how much value nurses bring to the 

legislative process. Nursing is a highly trusted profession. 

Legislators listen intently to our testimony. 

This is an example of nursing advocacy at work: 

• Nurses sharing clinical knowledge. 

• Nurses advocating for positive healthcare 

change. 

• Nurses collaborating with physicians and other 

healthcare professionals to promote a healthy 

New Hampshire. 

The executive leadership of New Hampshire Nurses 

Association is here to provide guidance and support 

throughout the process. If you want to get involved, 

we need you. Your clinical expertise is highly valued. 

The legislators benefit and are informed because of 

your professional involvement. The citizens of New 

Hampshire are well served by your expertise. 

Members of the Commission: 

• Representative Mariellen MacKay, Chair 

• Representative Peter Schmidt 

• Representative William March, 

Vice-Chair 

• Senator Donna Soucy 

• Patricia Tilley, NH DHHS, Clerk 

• April Kvetkosky, NH Society of Health- 

Systems Pharmacists 

• Christopher Lopez, NH Pharmacists 

Association 

• Michael Bullek, NH Board of Pharmacy 

• Robert Stout, NH Independent Pharmacy 

Association 

• Gary Sobelson, NH Medical Society 

• Lindsay Schommer, Board of Nursing 

• Joyce Cappiello, NH Nurse Practitioner 

Association 

• Amy Schneider, Board of Medicine 

Appointed Family Physician 

• Sara Kellogg Meade, NH Nurses 

Association 

• Ellen Joyce, American Congress of 

Obstetricians and Gynecologists 

• Mellissa Martinez-Adorno, NH Hospital 

Association 

• Jennifer Frizzell, Planned Parenthood of 

Northern New England 

• Diane Trowbridge, Bi-State Primary Care 

Bold indicates testified or present in-support of bill 

at hearings


IN MEMORY OF OUR COLLEAGUES 

The New Hampshire Nurses Association honors the 

memory of and acknowledges the work of deceased 

nurses who have graduated from New Hampshire 

nursing schools or who have actively practiced in New 

Hampshire during their career. Sharing the names and 

information about these nurses is one way we honor 

their contribution to the profession. Brief submissions are 

welcome. 

PNP 

Maureen “”Moe”” Angelini, 69, died 

unexpectedly on February 12, 2018. She 

graduated from Saint Anselm College in 

1970 with a degree in nursing. In 1973, 

she graduated from Johns Hopkins 

University with a Master of Public Health 

in Maternal and Child Health and 

Midwifery. She practiced women’s health and midwifery 

for 10 years in a variety of settings, from hospitals to 

universities, until obtaining a Master’s in Nursing with a 

concentration in pediatrics in 1987 from Yale University. 

Thereafter, she practiced nursing as a pediatric nurse 

practitioner, an adolescent health consultant for the State 

of New Hampshire, and as an ER nurse. She retired from 

practice in 2015. 

1953 Grad 

Geraldine (Gerry) N. (Hayward) Jeffery, 

86, passed away February 13, 2018. A 

1953 graduate of the former Elliot 

Community Hospital School of Nursing 

in Keene, she also attended Keene State 

College and the University of Vermont. 

She practiced for over 37 years, in the 

Portsmouth, Claremont, Concord and Keene Hospitals, 

in the doctor’s offices in Peterborough, and also as a 

private duty nurse in many family homes. She also 

volunteered with the American Red Cross blood drives 

for many years in both Concord and Keene. She was a 

charter member of the American Holistic Nurses 

Association. 

LPN 

Judith Ann (Golden) Lastowka, 73, 

passed away after a brief illness on 

February 19, 2018. She graduated as an 

LPN from Moore Hospital in Goffstown 

and worked at Southern New Hampshire 

Medical Center. 

Twin 

Elliot Grad 

Pauline (Polly) (Healy) Swenson, 91, died 

February 22, 2018. She graduated from 

Mount Saint Mary’s Nursing School with her 

twin, Patricia (Patsy) Prescott. As a nurse, 

Polly practiced with Concord physicians and 

later at Pleasant View Retirement Center and 

the Centennial Home. 

Ruth I. Lemear, 83, died February 23, 

2018. She was a diploma graduate of the 

Elliot Hospital School of Nursing before 

beginning a long nursing career. 

School Nurse 

Doreen Rose (Cusson) Dickner, 75, 

passed away on February 25, 2018, after 

a sudden illness. A Berlin native she was a 

1963 graduate of the Notre Dame School 

of Nursing in Manchester. Her nursing 

career included Lakes Region General 

Hospital St. Paul’s School infirmary, 

where she practiced for over 25 years. 

60 Year Career 

Constance M. (Largay) Bourgault, 80, 

died March 8, 2018. Her career spanned 

nearly 60 years when she retired from 

Ridgewood Center in Bedford. 

APRN 

Cheryl Ann (Gloddy) Gagnon, 52, passed 

away March 8, 2018, following a brief 

illness. Cheryl earned her RN from NHTI 

in Concord, and went on to earn a 

Master’s degree from St. Joseph College 

in Maine as a Nurse Practitioner. Cheryl 

compassionately cared for patients 

throughout her nursing career at both Concord Hospital 

and the Kidney Center. 

Concord Hospital Nurse 

Nathalie “Nat” (LaCross) Morin, of 

Concord, passed away March 9, 2018, 

two days from her 92th birthday. 

Receiving her nursing diploma in 1947 

she practiced at Concord Hospital for 

over 30 years until her retirement in 1988. 

JOIN OUR TEAM 

at Northeastern Vermont Regional Hospital, located in 

Vermont’s historic and rural Northeast Kingdom! NVRH is 

proud to offer a positive working community in which to 

grow, learn and excel in your profession. 

Life-Long Learner 

Sally T. (Thompson) Trombly, 78, passed 

away March 11, 2018. Sally obtained her 

nursing diploma from the Mary 

Hitchcock Hospital SON and after her 

children had grown, she furthered her 

education at Keene State College and 

received her Bachelors. She continued 

her studies at UMass Amherst, receiving a Masters in 

Public Health. Sally completed her studies at Suffolk 

University in 1990 with a Degree in Law. Before her 

retirement in 2011, she had held the position of Director 

of Risk Management at Dartmouth Hitchcock Medical 

Center in Lebanon. She was involved with the American 

Society for Healthcare Risk Management and the 

Anesthesia Patient Safety Foundation, publishing articles 

and reviewing grant requests. 

Gero Nurse 

Elizabeth May (Johnson) Reuter, 88, 

passed away March 13, 2018. After 

obtaining her nursing degree she 

practiced at Carol County nursing home 

until she retired. 

Keene Native 

Pauline Muriel Courchene, 93, passed 

away March 16, 2018 in Florida. A Keene 

native, she received her nursing diploma 

at the Elliott Hospital School of Nursing. 

She practiced in Concord and helped 

move into the new Concord Hospital 

when it was built. Later she was Dr. Paul 

Lena’s nurse at Internal Medicine retiring in 1980. 

LT Care Administrator 

Christine Sylvia (Vornberger) Arata, 54, 

died March 18, 2018 after a long battle 

with Multiple Sclerosis. She attended the 

University of New Hampshire where she 

received her Bachelor of Science degree 

in nursing, graduating Summa Cum 

Laude. She practiced at Exeter Hospital 

for a short period of time and then in administration at 

the Rockingham County Nursing Home in Brentwood 

for many years, where her kind and fun personality was 

a big hit with the residents. 

Mary Hitchock Grad 

Lucy “Jody” (Killary) Dupont, 90, 

passed away March 20, 2018. A Vermont 

native, she was a graduate of the Mary 

Hitchcock Memorial Hospital School of 


Maternity Nurse 

Janice Marie Sjoblom, 72, died March 

24, 2018 following a period of declining 

health related to late stage kidney failure. 

A diploma graduate, she practiced at 

Catholic Medical Center and then 25 

years at Elliot Hospital Labor and 

Delivery before retiring in 2007. Over 40 

years of nursing she cared for many mothers and babies. 

She mentored many nurses new to the specialty of 

Various Nursing and Nurse Practitioner positions are 

currently available in Med/Surg, Emergency Services, 

OR, Day Surgery and Physician Practices. 

New grads are welcome and encouraged to apply. 

For a full listing of available positions and to 

complete the online application, visit the Employment 

Opportunities pages at www.NVRH.org. 

NVRH offers competitive wages, shift differentials, per diem 

premiums and a generous benefits package for PT and FT 

employees working 20 or more hours per week. 

Benefits include medical, dental, vision, 401K retirement 

plan, tuition reimbursement, paid vacation days, 

membership to local gyms and more. 

NVRH is an Equal Opportunity Employer


IN MEMORY OF OUR COLLEAGUES 

Maternity nursing, leading to the saying, “What would 

Janice do?” 

LPN 

Sacred Heart Grad 

Marilyn Ann Dias, 74, passed away 

March 27, 2018. An LPN at the Maple 

Leaf Nursing Home, her passion 

was caring and interacting with the 

Alzheimer’s patients. She retired in 2015. 

Catherine A. Lynch (McSweenedy) 

Alie, 81 died March 29, 2018. She was 

a diploma graduate of the Sacred Heart 

School of Nursing in Manchester. 

1948 Grad 

Jacqueline “”Jackie”” (Garceau) 

Therrien, 90, passed away March 31, 

2018. She obtained her nursing diploma 

from the Notre Dame School of Nursing 

in 1948. After raising a family she 

returned to full-time nursing in 1970. In 

the early 1980s, she started in the 

substance-abuse field and she returned to college to 

complete her BS degree in 1982 from SNHU (then New 

Hampshire College). She continued to work at CMC on 

the Rush unit until she retired in 1992. After retiring from 

full-time work, she worked at the Bishop Peterson 

Residence and The Gale Home for a number of years. 

Stratham Grad 

Dawn Marie Delozier-Engel, 50, died 

April 1, 2018 following a long hard fought 

battle against cancer. She obtained her 

associate’s degree in nursing from the 

NHVTI Stratham. 

Manchester Native 

Eleanor M. “”Ellie”” (Dwyer) Kelliher, 

88, died April 2, 2018. After obtaining her 

nursing diploma she practiced at the 

Sacred Heart Hospital, for the 

Manchester Anesthesia Professional 

Association and the Catholic Medical 

Center. 

Psych Nurse and Educator 

Tracey Anne (Caldwell) Bergeron, 66, 

died from sudden onset nonalcoholic 

liver disease April 20, 2018. After 

graduating from the Concord Hospital 

School of Nursing, she obtained 

baccalaureate degrees from Plymouth 

State College, Graceland College and 

Kaplan University in education and nursing; Master’s 

degrees in Education and Human Services and Holistic 

Theology; held Nursing Certification in Forensic Nursing, 

School Nursing and Behavioral Health Nursing. And 

completed her Doctorate in Holistic Theology in 2004. 

She recently celebrated 30 years of service at 

Portsmouth Regional Hospital, mostly in psychiatric 

nursing. She was on the faculty of McIntosh College in 

Dover, NH for over a decade training LNA’s and Medical 

Assistants. After McIntosh, Tracey taught at Hesser 

College and Great Bay Community College along with 

supervising student clinical experiences in a variety of 

settings. Tracey loved her students and was proud of the 

many people she helped discover a career in nursing. 

Concord Hospital Grad 

Berlin Native 

Theresa Yvonne (Valorose) LaRoche, 81, 

died April 25, 2018. She was a diploma 

graduate of the Concord School of 

Nursing and practiced in Wolfeboro and 

then in Laconia. 

Juliette (Nadeau) LaPage, 96, passed 

away April 25, 2018. A Berlin native she 

earned her nursing diploma from the 

New Hampshire State Hospital School of 


Diabetes Educator 

Marjorie Jean (Cochrane) Connolly, 83 

passed away April 28, 2018. In addition to 

a career that spanned more than forty 

years of nursing, Marjorie was a diabetes 

educator, concluding her professional 

career at Catholic Medical Center. 

LTC Administrator 

Leslie Ann (Lamphier) Fabian, 59, died 

April 30, 2018 following breast cancer. 

After earning her nursing degree she was 

quickly promoted to the position of 

Director of Nursing which she held for 

the length of her career at multiple local 

nursing homes; most recently with 

Rockingham County. 

Cadet Nurse 

Anthie (Gatzoulis) Alexiou, 92, passed 

away May 1, 2018 in Florida. She 

obtained her nursing diploma from the 

Hillsboro County Hospital nursing school. 

During World War II, she was a cadet 

nurse. She practiced for over 40 years at 

the Elliot Hospital in Manchester where 

she was a head nurse. 

Psych Nurse 

OB Nurse 

Pedi Nurse 

Barbara J. (LeClair) Lillios, 80, died May 

3, 2018. She received her nursing 

diploma in 1959 from the NH Hospital 

School of Nursing. Barbara devoted her 

entire nursing career to the NH State 

Hospital, which spanned 37 years. 

Alice May (Gibbs) Head, 88, died May 5, 

2018. After obtaining a nursing diploma 

her career included Concord Hospital 

and OB/GYN Unlimited Birthing Center, 

which was owned by the late Dr. Gerald 

Hamilton and her dear friend, Christine 

Kuhlman. 

Sandra Joy (Wagner) Rioux, passed May 

8, 2018 in Plymouth, NH. She practiced 

as a pediatric nurse at Eliot and Memorial 

Hospitals. 

LPN 

Phyllis French Rogers, 97, died April 4, 

2018. She attended Elliot Hospital School 

of Nursing and was one of a group of 

nurses “The Fabulous Five.” She worked 

as an LPN in many capacities and at a 

local nursing home for 10 years until her 

retirement in 1971. 

1956 Grad 

Alyce C. (Mattson) Whitney, 82, passed 

away suddenly April 7, 2018. A 1956 

diploma graduate her career included 

Elliot Memorial Hospital in Keene, NH, 

and the Keene Clinic. 

Quality Nurse 

Linda Johnson, 69, died April 9, 2018 in 

Florida. As a nurse she received her Masters 

in Healthcare Administration from UNH. 

She consulted nationally on healthcare 

issues and established the Quality and Risk 

Management program and department for 

Wentworth-Douglass Hospital. 

Nurse Anesthestist 

Jana Steruska-Slezak, 52, passed away 

April 18, 2018. Born in Bratislava, 

Slovakia, after obtaining her nursing 

license and practicing in the PACU and 

the ICU, she furthered her education 

studying at the University of New 

England becoming a nurse anesthetist 

practicing at Portsmouth Regional Hospital. 

100 Saint Anselm Drive 

Manchester, NH 03102 

(603) 641-7086 

www.anselm.edu/cne 

Committed to Promoting Excellence 

in the Practice of Nursing 

Online programs now available.


Second Annual Nursing Research 

Symposium 

HUMOR ME 

Regularly exercising our sense 

of humor improves resiliency, 

positivity and balances antinegativity. 

Laughter may not 

solve problems but can change 

your chemistry allowing you to 

face them anew. In this issue 

“Humor Me” five vignettes that may bring a smile. 

Submissions are welcome. 

Dr. Richard Zourcha speaking at the 

Second Annual Nursing Research Symposium. 

On April 6th the Second Annual Nursing Research 

Symposium was held at the Fireside Inn in West 

Lebanon, NH. Sponsored by Dartmouth-Hitchcock, 

this day-long event provided an opportunity for nursing 

researchers from around the state to network and 

collaborate on their research endeavors. 

Susan Reeves, System Chief Nurse Executive from 

Dartmouth-Hitchcock Health, welcomed the fifty 

nurse researchers gathered. Elizabeth McGrath, a 

member of the planning committee for this event 

and a Nurse Practitioner in the Medical Oncology- 

Gastrointestinal Program at Dartmouth, provided 

some opening remarks and introduced the key 

note speaker, Dr. Richard Zoucha. Dr. Zoucha is 

the Joseph A. Lauritis, C.S.Sp. Endowed Chair for 

the Teaching and Technology, Professor and Chair 

of Advanced Role and PhD Programs, Duquesne 

University in Pittsburgh, Pennsylvania. Dr. Zoucha 

is an internationally recognized speaker on issues 

related to cultural care. His research interests include 

understanding various phenomena related to health 

and well-being in the Nicaraguan, Mexican American, 

African American and African refugee and immigrant 

communities. Dr. Zoucha is a qualitative and mixed 

method researcher experienced in ethnography, 

ethno-nursing, phenomenology and participatory 

action research method. He discussed cultural 

competence and translational research at this year’s 

conference. 

The nurse researchers then broke into work groups to 

discuss the different roles of the nurse researcher, the 

scientist, the transferor, the practitioner and the leader/ 

decision maker. Each of these groups was facilitated 

by a team of three nursing researchers/educators from 

Plymouth State University, University of Vermont Health 

Network, University of New Hampshire, Norwich 

University, University of Vermont, St. Anselm College, 

Colby-Sawyer College and Dartmouth-Hitchcock Health. 

Between these breakout sessions, the nurses were able 

to view posters prepared by many of the attendees 

that shared their research and related findings. Posters 

presentations included: 

• Increasing Pain Reassessment Documentation 

Compliance on an Inpatient Labor and Delivery 

Glencliff Home is accepting applications for 

Nursing Coordinator 

Salary Range: $68,952.00 – $81,931.20 additional 15% enhancement on salary base 

40 hours/week • 7am – 3pm • Direct Care $.50/hr 

Performs highly professional, therapeutic duties supervising the nursing care treatment 

program of all residents within the facility. Develops broad common goals in determining 

the objectives and policies of the department of nursing and Glencliff Home. 

MINIMUM QUALIFICATIONS: 

Education: Bachelor’s degree from a recognized college or university with major 

study in nursing, human services, psychology, or a related field. Each additional year of 

approved formal education may be substituted for one year of required work experience. 

Experience: Five years’ experience as a registered nurse. Each additional year of 

approved work experience may be substituted for one year of required formal education. 

License/Certification: 

• Current license as a Registered Nurse in New Hampshire. 

• Current certification in CPR. 

• Must be certified by the American Nurses Association or another nationally recognized 

certifying entity in Nursing Administration, Psychiatric and Mental Health or 

Geriatric Nursing. 

State of New Hampshire Benefit Package! 

Glencliff Home, 393 High Street, PO Box 76, Glencliff, NH 03238 

(603) 989-3111 Ext. 1303 

Doreen.Stevens@dhhs.nh.gov 

Applications can be completed online at 

https://das.nh.gov/hr/index.aspx 

or you can pick one up in the Human Resource Office Equal Opportunity Employer 

Dr. Pamela Kallmerten facilitating the breakout 

session on the Transferor of Research. 

Nicole Torrey, MSN in front of her poster on a 

Pediatric Code Cart Training Program. Nicole 

will be presenting her research in October at the 

Third Annual Global Conference on Nursing and 

Trauma Care in the Netherlands. 

Unit, Bethany Alrecht (Clinical Supervisor ICCU/ 

CSCU Dartmouth-Hitchcock) (Poster winner) 

• Plan of Safe Care for Substance-exposed Infants, 

Jane Eaton 

• Implementing the Standardized Nursing Handoff 

Tool IPASS in the Emergency Department, Katie 

Darak 

• Improving the Screening Process for Suicidal 

Ideation and Depression in Pediatric Inpatients 

at DHMC, Brittany Nyman 

• Enhancing Shared Decision Making, Meredith 

Fogg 

• Improving Patient Flow and Communication 

between PACU and 2 West, Jenna Parsons 

• Standardization of Daily Rounds, Kim Hill 

• Interprofessional Education in the Cardiovascular 

Critical Care Unit, Leslie Burke 

• Plan of Care Discussions, Indie LeClair 

• Decreasing Indwelling Urethral Catheter 

Utilization and CAUTI on 2 and 3 East Medical 

Specialties, Erica Leonard 

• Early Progressive Mobility in the SICU, Brianna 

Poulin 

• Improving Interdisciplinary Communication on a 

Medical Specialties Unit, Lindsey Thompson 

• Rolling Refresher Emergency Department 

Pediatric Code Cart Training Program, Nichole 

Torrey 

• Enhancing Bone Marrow Transplant (BMT) Care 

and Survivorship through the Patient Experience, 

Lisa Wesinger 

• Multipronged Approach to Improve Hand 

Hygiene in Acute Care Nurses, Karen Britt 

• Interprofessional Collaboration as an Approach 

to Understand and Address Failure to Rescue, 

Krystal McGovern 

• An Inpatient Rehabilitation Interprofessional 

Care Pathway for Traumatic Hip Fracture: A Pilot 

Study, Sarah Plante 

• Development of a Supportive Care Intervention 

for Caregivers of Patients Undergoing 

Hematopoietic Stem Cell Transplantations, 

Lynn Root (Blood and Marrow Transplant Nurse 

Coordinator, Section of Hematology/Oncology, 

Dartmouth-Hitchcock) (Poster Winner) 

• Does a “Track and Trigger” System Promote 

Timely Intervention? Heather Nolette 

• Developing Nurse Scientists of the Future: A 

Unique Clinical Academic Partnership, Jacob 

Pushee (Student Nurse, Colby Sawyer College) 

(Poster Winner) 

A student in a life science class was staring at his 

final exam. The question required four advantages 

of breast milk. He sighed and provided the first 

three answers that entered his head: 1. No need 

to boil; 2. Never goes sour; 3. Available whenever 

necessary. He frowned, scowled and sighed trying 

to think of a fourth answer. Finally he triumphantly 

wrote: 4. Available in attractive containers of 

varying sizes. 

____________________________________________ 

A little girl asked her mother, “How did the human 

race begin?” The mother answered, “God made 

Adam and Eve and they had children, and so all 

mankind was made.” The next day, the little girl 

asked her dad the same question, “How did the 

human race begin?” The father answered, “Many 

years ago, there were monkeys from which the 

human race evolved.” The confused girl, returned to 

her mother and said, “Mom, how is it possible that 

you told me the human race was created by God, 

and dad said they developed from monkeys?” The 

mother answered, “Well dear, it is very simple. I 

told you about my side of the family and your father 

told you about his.” 

____________________________________________ 

A Chemistry teacher wanted to demonstrate the 

evils of liquor, so he set up an experiment that 

involved a glass of water, a glass of whiskey and two 

worms. “Now class. Observe what happens to the 

two worms,” said the teacher, putting the first worm 

in the glass of water. The worm in the water moved 

about seemingly unharmed. He then dropped the 

second worm in the whiskey glass. It writhed in 

pain for a moment, then sank to the bottom and 

died. “Now kids, what lesson can we learn from this 

experiment?” he asked. Little Johnny raised his hand 

and wisely responded, “Drink whiskey and you 

won’t get worms!” 

____________________________________________ 

Three women were at a flume water slide at the top 

of a pool, a blonde, a brunette and a red-head. As 

they got to the top, a genie appeared from nowhere 

and said “When you are going down the flume 

shout out the one thing that you want and you will 

land in it at the bottom.” So the brunette went down 

and shouted “money” and landed in a load of cash. 

The red-head woman went down and shouted 

“gorgeous men” and landed in a pile of men. The 

blonde woman wasn’t listening to the genie, so she 

went down shouting weeeeeeeeeeeee. 

____________________________________________ 

A man in his mid-sixties bought a new BMW and 

was out for a drive on the interstate. The top was 

down, the breeze was blowing through what was 

left of his hair and he decided to see what the 

engine had. As the needle jumped up to 80 mph, 

he suddenly saw flashing red and blue lights behind 

him. “There is no way they can catch a BMW,’ he 

thought to himself and opened her up further. The 

needle hit 90, then 100, and finally reality hit him 

and he knew he shouldn’t run from the police so he 

slowed down and pulled over. The cop came up to 

him, took his license without a word, and examined 

it and the car. “It’s been a long day, it is the end of 

my shift and it is Friday the 13th. I don’t feel like 

more paperwork, so if you can give me an excuse 

for your driving that I haven’t heard before then I will 

let you go.” The guys thinks for a few seconds and 

says “Last week my wife ran off with a cop. I was 

afraid you were trying to give her back.” “Have a 

nice weekend,” said the officer and he walked away. 

Answers to NCLEX Reconsidered from page 12 

1. d 2. b 3. a, c, e 4. b 5. c


When Caring Isn’t Easy: 

Managing Responses to Our “Trigger” Patients 

Lorraine Gaddis, PhD, RN, FNP-BC 

Director, MNA Council on Nursing Research 

Reprinted from Mississippi RN 

December 2017, January, February 2018 

If we are honest, we all have at least one: The dreaded 

patient that triggers a negative response on a visceral 

level. For Melody, RN, whose interactions with 

patients were usually as harmonious as her name, it 

was the homeless woman who consistently sought 

narcotics. “When I say ‘homeless’ I mean she drifted 

among houses of friends who would let her crash for 

a few days. She was in the ED at least once a week 

begging for anything she could get. To cap it off, her 

hygiene was awful and I smelled her before I saw her. 

It frustrated me to see how she abused the welfare and 

health care delivery systems all because she couldn’t 

get off drugs. I found myself getting angry and uptight 

every time she came in.” 

Lorraine Gaddis, 

PhD, RN, FNP-BC 

Some of us have evolved past the very human 

tendencies to become angry, disgusted, sad, or fearful when encountering a 

certain patient or “type” of patient. However, for most of us, the struggle to be 

our best selves when encountering patients we can scarcely bear to be with 

remains all too real. We may never completely overcome our initial reactions 

to our “trigger” patients, but we can begin to improve our responses to these 

challenging situations. 

changed me. I don’t get caught up in the drama inside my own head when I 

focus and stay in the moment.” 

Seek wise mentoring 

We all need the opportunity to vent when we have an interaction with a patient 

whose attitude, diagnosis, behavior, or cultural history triggers a strong negative 

reaction in us. Certainly active listening, allowing mentees to vent, and “talking 

them down” are important mentoring skills. However, a true mentor will not 

simply listen to us vent and then offer unconditional validation. A mentor, by 

definition, will guide us through examining the disturbing interaction with 

the patient, but will also challenge us to confront the prejudices, biases, and 

unresolved issues in our lives that led to our negative responses. An effective 

mentor will help us step away from the situation, gain perspective, and answer 

hard questions for ourselves: Why am I so triggered by this situation? Is there 

some wound in my personal or professional past that I need to heal? What 

personal value do I hold dear that makes me utterly intolerant of this patient’s 

behavior? As a professional, what do I need to help me regain my balance when 

interactions with patients destroy my equanimity? 

In short, effective mentors will help us summon our wounded healers, learn 

to become centered in the present moment, and identify the sources of our 

triggers so we may begin to modify our responses. We need to remember that 

the person is not his or her disease. We need to recall the times in our own 

lives when “lousy” was absolutely the best we could do. Denny, RN, insists 

her mentor said it best, “My supervisor reminded me that I am in the business 

of healing, not judging. That was hard to hear until she told me that includes 

healing and not judging myself—because it is me that I am always hardest on!” 

Summon Your Wounded Healer 

Dr. Marion Conti-O’Hare asserted that all nurses, as human beings, have 

experienced trauma in their lives. Whether it is personal trauma, professional 

trauma, or a combination of both, there are times when situations with patients 

will trigger us. Trauma may occur from a critical event, like a physical assault or 

the death of a loved one, or from something we didn’t see as that important at 

the time, like being bullied by older nurses when we were fledgling RNs. 

After Registered Nurse David’s son died of cancer, he found himself overcome 

with grief and rage every time a patient who attempted suicide was admitted 

to the ICU. One night a colleague was brought in following an overdose, and 

in David’s words, “I lost it. I was so furious with her for trying to take her 

perfectly healthy life when my son fought so hard for his. My grief had become 

dysfunctional. I had to take some time off and get counseling.” 

Bibliography 

Bazarko, D. (2014). Mindfulness and you: Being present in nursing practice. 

Silver Spring, MD: American Nurses Association. 

Conti-O’Hare, M. (2002). The nurse as wounded healer: From trauma to 

transcendence. Sudbury, MA: Jones and Bartlett. 

Day-Calder, M. (2017). Giving equal care to the difficult patient. Nursing 

Standard, 31(48), 37-38. 

Watson, J. (2006). Caring theory as an ethical guide to administrative and clinical 

processes. Contemporary Nurse, 8(3), 87-93. 

If we are constantly triggered, we may be among those whom Conti-O’Hare 

describes as “the walking wounded.” When that wound interferes with the 

ability to function professionally, formal counseling is needed. However, with 

time and self-care this trauma can be transformed and transcended, then used to 

help others. We need to examine ourselves and accept with honesty when the 

patients who trigger us are touching a wound that hasn’t healed. Once we have 

worked through the healing process, we become “wounded healers.” We can 

then summon the healer within and therapeutically affect those whose physical 

or psychic pain responses used to trigger us, just as David did. “Once I took the 

time to grieve my loss, I was able to see that people who attempt suicide are 

invariably carrying their own load of grief. I was counseled, and now I am the 

counselor. My scars help me be a much better nurse.” 

Stay in the Moment 

Even after we have worked on our own healing, we need specific tools to 

help us through precarious moments. One helpful mechanism for dealing 

with difficult encounters involves staying in the moment. This may seem 

counterintuitive when all we want to do is run away. Fight or flight kicks in. 

There is an instinctive drive to either react defensively or to go someplace 

else in our minds when confronted with patients we find wholly unlikable or 

difficult. 

In the Theory of Human Caring, Dr. Jean Watson advocates maintaining 

authentic presence with patients. Authentic presence involves genuinely being 

with the patient and getting our egos out of the way. We practice mindfulness 

by very intentionally letting go of the triggering past and focusing on the present 

moment. We allow ourselves to recognize the humanness of the patient and 

ourselves. Staying in the moment immediately relieves an enormous amount 

of internal pressure. We are free to focus on the task at hand without reacting 

to our previous experiences. Purposefully fixed in the present, we can find 

compassion for almost any patient. We don’t take others’ behaviors personally, 

because our histories don’t interfere with our current responses. We use active 

listening skills to hear the patient’s message of fear and pain instead of thinking 

“This ungrateful man is a demanding hypochondriac.” We find understanding 

for the foster teen who is pregnant for the second time, realizing that she is 

desperately seeking love instead of saying “How dare she have another on tax 

dollars!” 

As Melody told me, “Once I was able to get in the moment, to remove myself 

from my former encounters with drug addiction, my intolerance disappeared 

and I actually heard the patient’s story. It turns out she was once a successful 

attorney who got addicted to narcotics after a horrible accident. She had chronic 

pain, and slipped off into the abyss. I see how easily it could all happen to me, 

too. I wish I could say that my authentic presence changed her. It didn’t. But it 

Hiring RN’s, LPN’s and LNA’s 

Across New Hampshire! 

Competitive wage scale | Excellent staffing ratios | Flexible working schedules 

Generous PTO, affordable insurance | 401K, life insurance 

Good Shepherd Rehabilitation and 

Nursing Center 

Jaffrey 

603-532-8762 

Mt. Carmel Rehabilitation and Nursing Center 

Manchester 

603-627-3811 

St. Ann Rehabilitation and Nursing Center 

Dover 

603-742-2612 

St. Francis Rehabilitation and Nursing Center 

Laconia 

603-524-0466 

St. Joseph Residence 

Manchester 

603-668-6011 

St. Teresa Rehabilitation and Nursing Center 

Manchester 

603-668-2373 

St. Vincent de Paul Rehabilitation and 

Nursing Center 

Berlin 

603-752-1820 

Warde Rehabilitation & Nursing Center - 

Windham 

603-890-1290 

Apply Online: www.cc-nh.org/jobs


Nutrition Message – How Bad is Chocolate, Really? 

Brion W. Moss, MS Nutrition, Special BS 

Nutrition, National Council of Strength and 

Fitness Personal Trainer, National Council of 

Strength and Fitness Sports Nutrition Specialist, 

New York City Health and Mental Hygiene Food 

Handlers License and National Restaurant 

Association ServSafe Certified 

Reprinted from Georgia Nursing 

May, June, July 2018 

Chocolate is enjoyed by people of all ages, ethnicities, 

religious groups and since the conception of human 

civilization (more than likely). Chocolate companies do 

target different age groups. Children enjoy sweets, so 

candies are made colorful and appealing to the eye. 

Adults enjoy chocolate just as much, but chocolate 

companies create nicely colored boxes and wrappings 

to appeal to a specific holiday or ones birthday. For 

example, Valentine ’s Day (red wrappings and heart 

shaped treats), Easter (solid chocolate rabbits and 

brightly colored eggs filled with chocolate) and people’s 

birthdays (chocolate cake with some sort of frosting). 

Companies even appeal to people that are a little bit 

more health conscious by using dark chocolate. 

The Hershey’s Company makes no health claims. 

However, it does state “Natural Source of Flavanol 

Antioxidants” on its Special Dark Chocolate Bar. This 

is not completely wrong; being that dark chocolate 

is a rich source of flavanols. Cocoa Powder (usually 

made from cocoa beans) is 100% cocoa and it is full of 

flavanols. Flavanols are a sub-class of flavanoids that are 

supposed to have positive effects on health in human 

beings. The flavanols found in dark chocolate/cocoa 

powder are epicateechin, catechin and procyanidins (an 

oligmers). 

These flavanols have been studied and results show 

they have protective factors against Cardiovascular 

Disease and possibly Type II Diabetes. As stated 

“the composition of cocoa flavanol-containing foods 

products can improve endothelial function, platlet 

reactivity, and reduce blood pressure”(1). However, 

current recommendations of these snack items suggest 

people should only eat these treats once in a while. 

This is due to the fact that chocolate products are full 

of added sugars and saturated fat. According to the 

National Cholesterol Education Program/American 

Heart Association “individuals older than 2 years of age 

consume a diet that provides < 30% of energy from fat, 

< 10% from saturated fat, and < 300 mg of cholesterol 

a day to reduce the risk of coronary heart disease” (3). 

The NCEP/AHA also puts “Milk Chocolate …in a listing 

of foods categorized as “decrease, limit, avoid” (3). The 

excessive intakes of these nutrients are linked to the 

aforementioned diseases, obesity and some cancers. 

Another recommendation to fight heart disease and 

diabetes from health professionals is; eat at least 5 fruits 

and vegetables a day (two fruit and three vegetables). 

They have other flavanoids (that act as antioxidants), 

vitamins and minerals that fight disease. Fruits and 

vegetables are also full of fiber so the sugars that they 

do have are burned at a moderate pace. Fiber also keeps 

your bowels moving. Other sources of flavanols found 

in chocolate are red wine and black tea. However, “dark 

chocolate contains catechins at an average of 0.535mg/g, 

4 times that of tea (139mg/L)” (6). Cocoa Powder 

contains “phenols that inhibit LDL oxidation by 75%, 

whereas red wines inhibited LDL oxidation by 37-65%” 

(6). As was stated earlier, they are a source of saturated 

fatty acid; but it is mostly stearic acid. This fatty acid is 

metabolized into oleic acid and mono-unsaturated fatty 

acid. Unsaturated fatty acids are healthy fats, good for 

the heart. 

A study was done where subjects were given a highcarb 

snack (a fig bar or graham cracker and juice) at 

first for a 21 day period. Then one milk chocolate bar a 

day for 21 days was given as a substitute for a high-carb 

snack. This was in addition to subjects following a Step1 

diet (eating a diet designed to reduce cholesterol). This 

diet developed by the NCEP/AHA contained a balance 

between fruits and veggies, 29% of energy from fat, 55% 

of energy from carbs and 16% energy from protein. 

This study revealed, having a high-carb snack increases 

the chances of having a coronary heart disease. Whereas 

a milk chocolate bar for a snack offers protection from 

coronary heart disease. This was because the milk 

chocolate bar shifted the amount of energy taken from 

fat (energy from fat


‘Right to Try’ Laws – An Ethical Dilemma for Nursing 

Donna Casey, DNP, MA, RN, NE-BC, FABC 

Reprinted from DNA Reporter 

May, June, July 2018 

Donna Casey DNP, MA, 

RN, NE-BC, FABC is a 

nurse executive and chair 

of the American Nurses 

Association Ethics and 

Human Rights Advisory 

Board. She can be reached 

at docasey@verizon.net. 

Terminally ill and dying 

patients and families are 

more technologically savvy 

than previous generations 

using internet resources 

to research treatment 

options (WebMD, 2018). 

New treatments are rapidly 

Donna Casey, 

DNP, MA, RN, 

NE-BC, FABC 

evolving. The process for investigational treatments 

to become Food and Drug Administration (FDA) 

approved and available to the public is long (FDA, 

2018). Desperate patients who have failed other 

treatments may be looking to slow the progression 

of their disease and delay death (Lowes, 2017). Do 

patients have a right to try investigational treatments 

as a last-ditch effort, and what are the ethical 

implications of administering potentially harmful 

medications? 

There are multiple pathways for terminally ill patients 

to obtain investigational medications. The intent of 

these pathways is to enable dying patients to receive 

investigational treatments outside of clinical trials 

and prior to FDA approval (Zettler & Greely, 2014). 

Right to Try legislation and compassionate use are the 

common routes. Right to Try legislation empowers 

patients to bypass the FDA and go directly to drug 

manufacturers and currently it exists in 36 states. 

Compassionate use regulations were established by 

the FDA to provide dying patients with faster access 

to investigational treatments (Zettler & Greely, 2014). 

The FDA usually approves requests for unapproved 

treatments for patients with serious or terminal 

condition when other treatments have failed or do 

not exist. Compassionate use regulation enables 

physicians to request the FDA to approve use of 

investigational treatments for dying patients. The 

physician obtains informed consent for compassionate 

use (Zettler & Greely, 2014). 

Right to Try laws and compassionate use regulations 

enable patients to obtain treatments that have 

completed phase 1 clinical trials. Phase 1 clinical 

trials evaluate safety, but not efficacy. The main 

purpose of phase 1 clinical trials is to determine the 

highest dose that can be safely given without causing 

serious side effects. Phase II clinical trials determine 

if the investigational treatment is effective (American 

to take charge of a pediatric unit, unless this were 

an extreme emergency, such as a disaster (in which 

case you would need to let people know your 

limitations, but you might still be the best person, 

given all factors for the assignment), it would 

be bad faith to take the assignment. It is always 

your responsibility to articulate your limitations 

and to get an adjustment to the assignment that 

acknowledges the limitations you have articulated. 

Good faith acceptance of the assignment means 

that you are concerned about the situation and 

believe that a different pattern of care or -policy 

should be considered. However, you acknowledge 

the difference of opinion on the subject between 

you and your supervisor and are willing to take the 

assignment and await the judgment of other peers 

and supervisors. 

Retrieved from American Nurses Association: http:// 

www.nursingworld.org/mainmenucategories/ 

thepracticeofprofessionalnursing/workforce/workforceadvocacy/questions-in-decision-to-accept-staffingassignment.html 

Cancer Society, 2017). In phase II and III clinical 

trials – some patients receive the standard therapy 

plus the experimental treatment while the control 

group receives standard therapy plus a placebo. 

Patients and providers are unaware who receives the 

active agent versus placebo to assure integrity of the 

research (Leuty, 2017). Patients using the Right to Try 

or compassionate use loopholes, subvert the clinical 

trials process assuring access to the active agent. Drug 

developers and manufacturers are reluctant to provide 

access to the investigational treatments. Concerns 

include negative publicity and impact on future FDA 

approval from treatment failures and patient harm, 

impact on supply of investigational agents for clinical 

trials, diluted clinical trials or confused efficacy studies 

and decreased availability of appropriate patients to 

participate in clinical trials (Zettler & Greely, 2014). 

Fear of negative publicity on social media has been 

a strong motivator for manufacturers to provide 

investigational treatment access despite concerns 

(Zettler & Greely, 2014). The FDA has stringent 

approval processes developed to protect the public 

from treatments that cause more harm than benefit. 

While manufacturers have the ultimate authority to 

permit or deny access to experimental treatments for 

dying patients, negative publicity from social media 

may impact those decisions. Approximately 90% of 

medications that enter phase 1 safety trials never make 

it to market because they don’t work or have side 

effects that outweigh benefit (Leuty, 2017). 

Cost of medications is another concern for right to try 

legislation. There is no price limit for investigational 

treatments under Right to Try legislation. Insurance 

companies rarely cover investigational treatments 

(Lowes, 2017). Compassionate use FDA regulations 

limit what manufacturers can charge. Patients 

who participate in clinical trials do not pay for 

investigational treatments or associated testing. This 

presents a justice concern for patients who cannot 

afford access to investigational treatments under right 

to try legislation. 

Ethically, the challenge is to balance the patients 

need for hope and potential for benefit with the 

obligation to not cause harm. Multiple provisions 

in the American Nurses Association Code of Ethics 

(ANA, 2015) inform this issue. Provision 1 states 

that “The nurse practices with compassion and 

respect for the inherent dignity worth and unique 

attributes of every person.” Establishing a trusting 

relationship, considering patients’ needs and 

respecting their religious, spiritual, and cultural 

values and right to self-determination would seem 

to require nurses to advocate for and assist patients 

to obtain investigational treatments if the request 

is consistent with their values and the patient and 

family are fully informed. Provision 2 states that “The 

nurses’ primary commitment is to the patient…” This 

would also indicate the nurse would be required 

to advocate for access to investigational treatments 

above concerns for the clinical trials process. This is 

somewhat conflicting as Provision 2 also identifies 

the patient as a population and community. There is 

a risk to the population of patients in need of safe and 

effective treatments when the clinical trials process is 

subverted for individual, unapproved use. Provision 

3: “The nurse promotes, advocates for and protects 

the rights, health and safety of the patient” addresses 

RN’s and LNA’s Wanted! 

FT, PT and perdiem positions available. Great 

starting pay with raise in 90 days! Excellent benefit 

package for those who qualify including health, 

dental, life, 401k with employer match, disability, 

prepaid legal, shift differentials, generous PTO plan 

and more! Must have valid NH RN or LNA license. 

Please submit application to Human Resources, 

Webster at Rye, 795 Washington Road Rye, NH 03870 

or email to info@websteratrye.com. 

the importance of informed consent for participation 

in research. This would seemingly apply for access to 

investigational treatments outside the research process 

as well. Special concern for vulnerable patients is also 

addressed in provision 3 (ANA, 2015). Terminally ill, 

desperate patients would be considered vulnerable, 

raising the bar for assuring fully informed consent to 

receive investigational treatments. Zettler and Greely 

(2017) proposed IRB oversight as another layer of 

protection for informed consent processes. Protection 

for health and safety addressed in provision 3 seems 

to indicate that investigational treatments should not 

be provided. Scientifically complex treatments should 

be proven through the rigorous clinical trials and FDA 

approval process (Zettler & Greely, 2014). Provision 

4 states “The nurse has authority, accountability and 

responsibility for nursing practice; makes decisions; 

and takes action consistent with the obligation to 

promote health and to provide optimal care.” Nurses 

bearing primary responsibility for the nursing care 

provided to patients, their judgments, decisions, 

and actions require reflection on the provision of 

unapproved investigational treatments because the 

harm that can result are unknown. Creating false hope 

for terminally ill patients and families can be harmful 

when it prevents preparation for the dying process. 

Nurses are highly likely to encounter a patient dying 

from a condition where research and investigational 

treatments are being developed. Desperate patients 

and families are more likely to investigate options 

more so today, than in years past. Nurses need to 

be prepared to engage in discussions that support 

patient self-determination with information and 

an ethical foundation. The ANA Code of Ethics 

provides the ethical framework to support nurses 

in these discussions and deliberations in balancing 

ethical obligations to support self-determination and 

autonomy while also maintaining patient safety. 

References 

American Cancer Society. (2017, February). Clinical Trials: 

What you need to know. Retrieved from American 

Cancer Society: https://www.cancer.org/treatment/ 

treatments-and-side-effects/clinical-trials/what-you-needto-know/phases-of-clinical-trials.html 

ANA. (2015). Nursing World. Retrieved from Code of Ethics: 

http://nursingworld.org/DocumentVault/Ethics-1/Codeof-Ethics-for-Nurses.html 

FDA. (2018, January). FDA Drug Development and 

Approval Process. Retrieved from FDA. Gov: https:// 

www.fda.gov/Drugs/DevelopmentApprovalProcess/ 

DrugInnovation/ucm537040.htm 

Leuty, R. (2017, June 8). The right to try: Terminally ill 

patients say trying experimental drugs offers hope. 

But is it just false hope? San Francisco Business Times, 

NA. Retrieved from https://www.bizjournals.com/ 

sanfrancisco/news/2017/06/08/biotech-2017-right-to-trylaws-biomarin-fda-ca.html 

Lowes, R. (2017, August). Senate passes right to try bill. 

Retrieved from Medscape: https://www.medscape.com/ 

viewarticle/883776 

Tsakopoulis, A., Han, J., Nodler, H., & Russo, V. (2015). 

Student Note: The right to try; An overview of efforts to 

obtain expedited access to unapproved treatments for 

the terminally ill. Food Drug Law Journal, 70 (4). 617 - 

641. 

WebMD. (2018). WebMD. Retrieved from About WebMD: 

https://www.webmd.com/about-webmd-policies/default. 

htm 

Zettler, P., & Greely, H. (2014). The strange allure of state 

“Right to Try” laws. JAMA, 174(12). 1885 - 1886.

Quality Care Close to Home 

North Country Hospital is a 25 bed critical access private, nonprofit acute care 

community hospital with physician practices serving twenty communities in a twocounty 

area in the rural Northeast Kingdom of Vermont. 

We are currently seeking applicants for 

the following positions: 

Emergency Room - 4 Full Time 

Med/Surg, RN - 2 Full Time 

ICU, RN - 1 Full Time, 1 Part Time & 1 Per Diem 

Nursing FLEX Pool, RN - 1 Full Time & 1 Part Time 

PACU, RN - 1 Full Time 

Operating Room, RN - 2 Full Time & Per Diem 

New Graduate Nurse RN accepting online applications for PACU & 

Operating Room 

NC Surgical Associates & Urology Practice, RN/ LPN Office Nurse - 1 Full Time 

Primary Care Newport, RN/ LPN Office Nurse - 1 Per Diem 

Primary Care Barton, RN/ LPN Office Nurse - 1 Full Time 

At North Country Hospital quality patient care is our greatest commitment, employees 

are our greatest asset, excellent patient experience is our greatest accomplishment, 

and the health of the community is our greatest responsibility. 

For additional information contact: Tina Royer, Human Resources 

(802) 334-3210, ext. 407 • E-Mail: troyer@nchsi.org 

North Country Hospital, 189 Prouty Drive, Newport, VT 05855 

www.northcountryhospital.org

New Hampshire Nursing News - July 2018

Create successful ePaper yourself

Delete template?

Save as template?